Provider Demographics
NPI:1881789170
Name:GIANGARDELLA, MARK E (RPH)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:E
Last Name:GIANGARDELLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 CARRINGTON ST NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720
Mailing Address - Country:US
Mailing Address - Phone:330-494-4563
Mailing Address - Fax:
Practice Address - Street 1:2526 W TUSCARAWAS ST
Practice Address - Street 2:MEDICINE SHOPPE PHARMACY
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708
Practice Address - Country:US
Practice Address - Phone:330-455-5422
Practice Address - Fax:330-455-7778
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03314214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist