Active NPI
Laura Bodak, PHARM D.
- Pharmacist
- Medina, OH
National Provider Identifier
1740576255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03326860
- Practice address
- 1015 N. Court St.
CVS 16379
Medina, OH 44256 - Phone
- (330) 725-2706
- NPI assigned
- Jun 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 03326860 | OH | Primary |
Addresses
Primary practice location
1015 N. Court St.
CVS 16379
Medina, OH 44256
Mailing address
1015 N. Court St.
CVS 16379
Medina, OH 44256
Phone (330) 725-2706
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03326860 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1740576255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 N. COURT ST.",
"address_2": "CVS 16379",
"city": "MEDINA",
"state": "OH",
"postal_code": "44256",
"telephone_number": "330-725-2706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 N. COURT ST.",
"address_2": "CVS 16379",
"city": "MEDINA",
"state": "OH",
"postal_code": "44256",
"telephone_number": "330-725-2706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODAK",
"first_name": "LAURA",
"name_prefix": "Dr.",
"credential": "PHARM D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-22",
"last_updated": "2020-12-03",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03326860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.