Organization
MARK V COBERLY
Active
Other names
Village Green Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARK COBERLY (OWNER)
(330) 896-0212
Entity
Organization
Contact information
Practice address
4195 MASSILLION RD, STE B, UNION TOWN, OH 44685
(330) 896-0212
(330) 896-0682
Mailing address
4195 MASSILLION RD, STE B, UNION TOWN, OH 44685
(330) 896-0212
(330) 896-0682
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03 2 12837
OH
333600000X
Pharmacy
Primary
02588950
OH
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0573955
—
OH
01
—
3642750
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/25/2006
Last updated
07/15/2008
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