Organization
PHARMCO MANAGEMENT, LLC
Active
Other names
Compounding Pharmacy of Green
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSARIO S CARCIONE PHARMD (PRESIDENT)
(330) 899-0406
Entity
Organization
Contact information
Practice address
4016 MASSILLON RD STE B, UNIONTOWN, OH 44685-7818
(330) 899-0406
(330) 899-0652
Mailing address
877 HIDDEN VALLEY DR, WADSWORTH, OH 44281-9282
(330) 232-1255
(330) 899-0652
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0232000218
LICENSE TO DISTRIBUTE DANGEROUS DRUGS
OH
05
—
0426880
—
OH
01
—
1336735901
NPI
—
01
—
3688554
NCPDP
—
Enumeration date
12/17/2020
Last updated
12/06/2021
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