# CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC
- **Other names:** Crystal Clinic Orthopaedic Center Outpatient Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467979971
- **Legal business name:** CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC
- **Authorized official:** PATRICIA E WALDER RPH (MANAGER PHARMACY OPERATIONS)
- **Authorized official phone:** (330) 379-5125

## Contact information

- **Practice address:** 444 N MAIN ST FL 1, AKRON, OH 44310-3110
- **Practice address phone:** (330) 379-5125
- **Practice address fax:** (330) 379-9086
- **Mailing address:** 444 N MAIN ST FL 1, AKRON, OH 44310-3110
- **Mailing address phone:** (330) 379-5125
- **Mailing address fax:** (330) 379-9086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | PMY02264650-03 | OH | Yes |

## Other

- **Enumeration date:** 08/25/2017
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3685293 | NCPDP | OH |
| 01 | — | PMY-022646650-03 | STATE OF OHIO BOARD OF PHARMACY | OH |