Organization
CEDARVILLE HOMETOWN PHARMACY LLC
Active
Other names
Cedar Care Village Pharmacy, Cedar Care Village Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE PERRY (OWNER)
(937) 336-3637
Entity
Organization
Contact information
Practice address
63 N. MAIN ST., CEDARVILLE, OH 45314
(937) 766-2273
(937) 697-5086
Mailing address
PO BOX 662, CEDARVILLE, OH 45314
(937) 766-2273
(937) 697-5086
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
022553950
OH
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023000050
OHIO BOARD OF PHARMACY TERMINAL DISTRIBUTORS LICENSE
OH
05
—
0332877
—
OH
Enumeration date
01/13/2016
Last updated
11/17/2023
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