Basic Information
| Provider Information | |||||||||
| NPI: | 1467446971 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RECH | ||||||||
| FirstName: | GLENN | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | R.PH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 929 KING GEORGE BLVD | ||||||||
| Address2: | |||||||||
| City: | SOUTH EUCLID | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441213407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164101613 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2351 E 22ND ST | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441153111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168616200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | 03113538 | OH | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.