Provider Demographics
NPI:1821703133
Name:UH PARMA RETAIL PHARMACY
Entity Type:Organization
Organization Name:UH PARMA RETAIL PHARMACY
Other - Org Name:UH PARMA RETAIL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-935-2753
Mailing Address - Street 1:7007 POWERS BLVD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7007 POWERS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5437
Practice Address - Country:US
Practice Address - Phone:440-743-4032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UH MEDS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-20
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy