Organization
PHARMACY SPECIALTY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID J COURY (MEMBER)
(216) 390-5830
Entity
Organization
Contact information
Practice address
6910 TREELINE DR STE G, BRECKSVILLE, OH 44141
(440) 623-7100
Mailing address
6910 TREELINE DR STE G, BRECKSVILLE, OH 44141-3366
(440) 623-7100
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
SP 022216250
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP 022216250
PHARMACY LICENSE
OH
Enumeration date
07/30/2012
Last updated
06/22/2018
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