Organization
CHURCH SQUARE PHARMACY INC.
Active
Other names
CLEVELAND LOWCOST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ABDEL ABUKHALIL (PRESIDENT)
(216) 288-0557
Entity
Organization
Contact information
Practice address
14529 PURITAS AVE, CLEVELAND, OH 44135-2813
(216) 476-1400
(216) 476-1401
Mailing address
14529 PURITAS AVE, CLEVELAND, OH 44135-2813
(216) 476-1400
(216) 476-1401
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RTP02242760003
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145685
PK
—
05
—
2145685
—
OH
Enumeration date
07/07/2014
Last updated
04/22/2025
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