Provider Demographics
NPI:1629045976
Name:SKILLED CARE PHARMACY,LLC
Entity Type:Organization
Organization Name:SKILLED CARE PHARMACY,LLC
Other - Org Name:SKILLED CARE PHARMACY, LLC - CLEVELAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:GALLUZZO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:800-334-1624
Mailing Address - Street 1:6175 HI TEK CT
Mailing Address - Street 2:SKILLED CARE PHARMACY, LLC
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-2603
Mailing Address - Country:US
Mailing Address - Phone:513-459-7455
Mailing Address - Fax:513-459-8278
Practice Address - Street 1:9299 MARKET PL
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2865
Practice Address - Country:US
Practice Address - Phone:855-765-9400
Practice Address - Fax:800-688-1638
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SKILLED CARE PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-07
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0222859003336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3674353OtherNABP NUMBER