Mario Michael Iacano, PHARM D.
Individual provider Active NPI Pharmacist · Bellaire, OH
NPI 1760936728 · NPPES record last updated Aug 8, 2016
Key facts
- NPI
- 1760936728
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03136177 (OH)
- Practice address
- 428 34TH St
Bellaire, OH 43906-1538 - Phone
- (740) 676-5621
- NPI assigned
- Aug 8, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03136177 | OH | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03136177 | OH | Yes |
Addresses
Primary practice location
428 34TH St
Bellaire, OH 43906-1538
Mailing address
428 34TH St
Bellaire, OH 43906-1538
Phone (740) 676-5621
Other providers in Bellaire, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2016. 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.