Coventry Plaza Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

021599100 Issued in OH

Legal business name

COVENTRY PLAZA PHARMACY INC

Doing business as

Southside Pharmacy

Practice address

2811 Fulton Rd
Ste B
Lorain, OH 44055-1638

Phone

(440) 277-0655

Fax

(440) 277-0651

NPI assigned

Dec 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sbeih Sbeih, RPH

Title

Owner

Phone

(440) 277-0655

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SOUTHSIDE PHARMACY Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Domia Taher

  • Pharmacist
  • Cleveland, OH
  • NPI 1568172641
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1225191851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 FULTON RD",
            "address_2": "STE B",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440551638",
            "telephone_number": "440-277-0655",
            "fax_number": "440-277-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 FULTON RD",
            "address_2": "STE B",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440551638",
            "telephone_number": "440-277-0655",
            "fax_number": "440-277-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENTRY PLAZA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "SBEIH",
        "authorized_official_first_name": "SBEIH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-277-0655",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021599100",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2701580",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2080565",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHSIDE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neyscha Anayz Cortez
• Patricia Martinez Cortez, STNA #40099791109
• Steven Cotman, M.D.
• Trinity Coughlin
• Melissa Nicole Counts, LISW
• Craig William Cowles, QMHS MA CMS MA
• Maryann Elizabeth Cox, NP-C
• Lavinia M Cozmin, MD
• Dana L Crawford, R.N
• Creative Enrichment Centers of Ohio, LLC

• Community/Retail Pharmacy in Lorain, OH
• Providers in Lorain, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.