Provider Demographics
NPI:1770566770
Name:MEDADVICE LLC
Entity type:Organization
Organization Name:MEDADVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:COUSINO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:440-331-3360
Mailing Address - Street 1:21851 CENTER RIDGE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3976
Mailing Address - Country:US
Mailing Address - Phone:440-331-3360
Mailing Address - Fax:440-331-3306
Practice Address - Street 1:21851 CENTER RIDGE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3976
Practice Address - Country:US
Practice Address - Phone:440-331-3360
Practice Address - Fax:440-331-3306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty