Provider Demographics
NPI:1447469093
Name:DRUG MART PHARMACY
Entity type:Organization
Organization Name:DRUG MART PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIEMIANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-871-6077
Mailing Address - Street 1:550 GLEN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2450
Mailing Address - Country:US
Mailing Address - Phone:440-897-1823
Mailing Address - Fax:
Practice Address - Street 1:27255 DETROIT RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2228
Practice Address - Country:US
Practice Address - Phone:440-871-6077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06005267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty