MEDICARE: DR. ASMAA OUDABACHI RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03439735	OH

General Provider Information

NPI Number	:	1871284851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASMAA OUDABACHI RPH

Provider Business Mailing Address
First Line	:	12128 SYCAMORE TERRACE DR APT D
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45249-8110
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12128 SYCAMORE TERRACE DR APT D
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45249-8110
Country	:	US
Telephone Number	:	903-441-3692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2023
Last Update Date	:	05/18/2023

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