Organization
RIVEON MENTAL HEALTH AND RECOVERY
Active
Other names
Riveon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE MCDONALD PHARMD, RPH (DIRECTOR OF PHARMACY)
(440) 204-4307
Entity
Organization
Contact information
Practice address
6140 S BROADWAY, LORAIN, OH 44053-3821
(440) 204-4307
(440) 204-4307
Mailing address
6140 S BROADWAY, LORAIN, OH 44053-3821
(440) 204-4307
(440) 204-4307
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
RTP.022397550-03
OH
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111910
—
OH
Enumeration date
10/10/2014
Last updated
09/17/2024
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