Tyler Simmons-Eakin
Individual provider Active NPI Pharmacist · Sagamore Hills, OH
NPI 1104544816 · NPPES record last updated Aug 18, 2022
Key facts
- NPI
- 1104544816
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03237133 (OH)
- Practice address
- 550 W Aurora Rd
Sagamore Hills, OH 44067-2108 - Phone
- (330) 468-4868
- NPI assigned
- Aug 18, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03237133 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marc Glassman Inc | Past |
Accepting new patients | |
| Marc Glassman Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03237133 | OH | Yes |
Addresses
Primary practice location
550 W Aurora Rd
Sagamore Hills, OH 44067-2108
Mailing address
550 W Aurora Rd
Sagamore Hills, OH 44067-2108
Other providers in Sagamore Hills, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.