Provider Demographics
NPI:1932240322
Name:PARMA DRUG INC
Entity type:Organization
Organization Name:PARMA DRUG INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:440-331-8509
Mailing Address - Street 1:21724 LORAIN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-3334
Mailing Address - Country:US
Mailing Address - Phone:440-331-8509
Mailing Address - Fax:440-331-8519
Practice Address - Street 1:21724 LORAIN RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-3334
Practice Address - Country:US
Practice Address - Phone:440-331-8509
Practice Address - Fax:440-331-8519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2349864Medicaid