Basic Information
Provider Information
NPI: 1003004060
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRUMAN JONES
FirstName: MICHELE
MiddleName: DENISE
NamePrefix: DR.
NameSuffix:  
Credential: PHARM. D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2171 MEADOWSWEET LN
Address2:  
City: STREETSBORO
State: OH
PostalCode: 442415908
CountryCode: US
TelephoneNumber: 3304220094
FaxNumber:  
Practice Location
Address1: 2181 E AURORA RD
Address2: SUITE 201
City: TWINSBURG
State: OH
PostalCode: 440871974
CountryCode: US
TelephoneNumber: 3304058080
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/04/2007
LastUpdateDate: 10/04/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X03-2-25314OHY Pharmacy Service ProvidersPharmacist 

No ID Information.


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