Organization
PHARMACY COUNTER LLC
Active
Parent organization
PROMEDICA PHYSICIAN GROUP, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROMEDICA PHYSICIAN GROUP, INC.
Authorized official
MISSY CROSS (GENERAL MANAGER)
(419) 473-1473
Entity
Organization
Contact information
Practice address
2005 E 28TH ST STE 2, LORAIN, OH 44055-1908
(440) 277-8922
(440) 277-0641
Mailing address
2655 W CENTRAL AVE, TOLEDO, OH 43606-3550
(419) 473-1493
(419) 474-7137
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
10/23/2017
Last updated
04/12/2018
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