Active NPI
Marc Glassman Inc
- Community/Retail Pharmacy
- Lakewood, OH
National Provider Identifier
1659386597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- MARC GLASSMAN INC
- Doing business as
- MARCS
- Practice address
- 14861 Detroit Ave
Lakewood, OH 44107-3909 - Phone
- (216) 521-2191
- Fax
- (216) 521-2291
- NPI assigned
- Jul 29, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Beth Halloran
- Title
- Pharmacy Admin
- Phone
- (216) 265-7700
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 20729050 | OH | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
14861 Detroit Ave
Lakewood, OH 44107-3909
Mailing address
5841 W 130TH St
Parma, OH 44130-9308
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0909619 | Medicaid | OH | |
| 3657826 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- MARCS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110719000437 | OH | Part B Supplier - Mass Immunization (Roster Biller Only) | 3779602362 |
40 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Rocky River, OH; Medina, OH; Mentor, OH; Middleburg Heights, OH; N Ridgeville, OH; North Canton, OH; Parma, OH; Massillon, OH… |
Other NPIs on the same Medicare enrollment 40
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
14861 Detroit Ave
Lakewood, OH 44107
Phone (216) 521-2191
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Lakewood, OH
- NPI 1396348835
-
- Pharmacist
- Lakewood, OH
- NPI 1467055343
-
- Pharmacist
- Mentor, OH
- NPI 1174176317
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154131200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1485734400000",
"number": "1659386597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5841 W 130TH ST",
"city": "PARMA",
"state": "OH",
"postal_code": "441309308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14861 DETROIT AVE",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441073909",
"telephone_number": "216-521-2191",
"fax_number": "216-521-2291"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARC GLASSMAN INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-29",
"last_updated": "2017-01-30",
"status": "A",
"authorized_official_last_name": "HALLORAN",
"authorized_official_first_name": "MARY BETH",
"authorized_official_title_or_position": "PHARMACY ADMIN",
"authorized_official_telephone_number": "216-265-7700"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "OH",
"license": "20729050",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0909619",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3657826",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MARCS",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lakewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.