# BELLEVUE MEDICINE SHOPPE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Champion Medicine Shoppe
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720316029
- **Authorized official:** MRS. ASHLEY RENEE DUDLEY PHARMD-DOCTORATE (PHARMACY MANAGER)
- **Authorized official phone:** (330) 847-8000

## Contact information

- **Practice address:** 4619 MAHONING AVE., WARREN, OH 44483
- **Practice address phone:** (330) 847-8000
- **Practice address fax:** (330) 847-7708
- **Mailing address:** 4619 MAHONING AVE., WARREN, OH 44483
- **Mailing address phone:** (330) 847-8000
- **Mailing address fax:** (330) 847-7708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 022001250 | OH | Yes |
| 333600000X | Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 11/24/2009
- **Last updated:** 06/26/2015