Healthcare Provider Details

I. General information

NPI: 1083547574
Provider Name (Legal Business Name): MAHALA RENEE SMITH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 W MAIN ST
AMELIA OH
45102-1309
US

IV. Provider business mailing address

4530 EASTGATE BLVD STE 500
CINCINNATI OH
45245-1256
US

V. Phone/Fax

Practice location:
  • Phone: 513-718-2220
  • Fax: 513-718-2221
Mailing address:
  • Phone: 513-943-6340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03446664
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: