Provider Demographics
NPI:1700109345
Name:MDCS, MEDICATION AND DISEASE CONSULTING SERVICES
Entity Type:Organization
Organization Name:MDCS, MEDICATION AND DISEASE CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:WITLICKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:440-632-0284
Mailing Address - Street 1:8635 MAYFIELD RD OFC 11A
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2659
Mailing Address - Country:US
Mailing Address - Phone:440-632-0284
Mailing Address - Fax:440-632-0133
Practice Address - Street 1:8635 MAYFIELD RD OFC 11A
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2659
Practice Address - Country:US
Practice Address - Phone:440-632-0284
Practice Address - Fax:440-632-0133
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RODIKA ENTERPRISES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCPO0220293503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy