Organization
WITTENAUER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MICHAEL GOMEZ RPH. (PHARMACIST IN CHARGE)
(330) 757-4033
Entity
Organization
Contact information
Practice address
120 S MAIN ST, POLAND, OH 44514-2023
(330) 757-4066
(330) 757-6070
Mailing address
120 S MAIN ST, POLAND, OH 44514-2023
(330) 757-4066
(330) 757-6070
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
OH
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9595326
—
OH
Enumeration date
01/29/2007
Last updated
03/21/2008
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