Provider Demographics
NPI:1851306799
Name:MARCS PHARMACY
Entity Type:Organization
Organization Name:MARCS PHARMACY
Other - Org Name:MARCS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:3RD PARTY ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-265-7700
Mailing Address - Street 1:5841 W 130TH ST
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44130-9308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13883 CEDAR RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44118-3202
Practice Address - Country:US
Practice Address - Phone:216-932-1090
Practice Address - Fax:216-932-4015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20431800333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0945688Medicaid
3644069OtherOTHER ID NUMBER-COMMERCIAL NUMBER