# RIVEON MENTAL HEALTH AND RECOVERY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riveon Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063816601
- **Authorized official:** JESSE MCDONALD PHARMD, RPH (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (440) 204-4307

## Contact information

- **Practice address:** 6140 S BROADWAY, LORAIN, OH 44053-3821
- **Practice address phone:** (440) 204-4307
- **Practice address fax:** (440) 204-4307
- **Mailing address:** 6140 S BROADWAY, LORAIN, OH 44053-3821
- **Mailing address phone:** (440) 204-4307
- **Mailing address fax:** (440) 204-4307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | RTP.022397550-03 | OH | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/10/2014
- **Last updated:** 09/17/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0111910 | — | OH |