Active NPI
Elizabeth Potak, RPH
- Pharmacist
- Brunswick, OH
National Provider Identifier
1396045472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03122827
- Practice address
- 3688 Center Rd
Brunswick, OH 44212-3620 - Phone
- (330) 225-0202
- NPI assigned
- Oct 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03122827 | OH | Primary |
Addresses
Primary practice location
3688 Center Rd
Brunswick, OH 44212-3620
Mailing address
17085 Woodlawn CT
Strongsville, OH 44149-5910
Phone (440) 238-6438
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03122827 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287792000000",
"number": "1396045472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17085 WOODLAWN CT",
"city": "STRONGSVILLE",
"state": "OH",
"postal_code": "441495910",
"telephone_number": "440-238-6438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3688 CENTER RD",
"city": "BRUNSWICK",
"state": "OH",
"postal_code": "442123620",
"telephone_number": "330-225-0202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTAK",
"first_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-23",
"last_updated": "2010-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03122827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.