Provider Demographics
NPI:1306310628
Name:BITZ, NICHOLAS DANIEL (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:DANIEL
Last Name:BITZ
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19875 CENTER RIDGE RD APT 439
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3655
Mailing Address - Country:US
Mailing Address - Phone:440-821-8689
Mailing Address - Fax:
Practice Address - Street 1:3909 ORANGE PL STE 1100
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4480
Practice Address - Country:US
Practice Address - Phone:216-896-1825
Practice Address - Fax:216-896-1824
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6382183500000X
OH03334585183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist