# ASHTABULA COUNTY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ACMC HEALTHCARE SYSTEM PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437552866
- **Authorized official:** BARRY SHICK PHARMD (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (440) 997-6276

## Contact information

- **Practice address:** 2420 LAKE AVE, PHARMACY DEPARTMENT, ASHTABULA, OH 44004-4954
- **Practice address phone:** (440) 997-6276
- **Practice address fax:** (440) 997-6679
- **Mailing address:** 2420 LAKE AVE, PHARMACY DEPARTMENT, ASHTABULA, OH 44004-4954
- **Mailing address phone:** (440) 997-6276
- **Mailing address fax:** (440) 997-6679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | HOS.020040800-03 | OH | Yes |
| 3336I0012X | Institutional Pharmacy | — | NULL | — |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/30/2014
- **Last updated:** 02/02/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0117272 | — | OH |
| 05 | — | 0289343 | — | OH |
| 01 | — | 2074026 | PK | — |