Individual
DIANA BANOUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7710 CHIPPEWA RD, BRECKSVILLE, OH 44141-2312
(440) 546-1655
Mailing address
7710 CHIPPEWA RD, BRECKSVILLE, OH 44141-2312
(440) 546-1655
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03233372
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1954776039
—
OH
Enumeration date
11/30/2020
Last updated
11/30/2020
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