Healthcare Provider Details

I. General information

NPI: 1124611629
Provider Name (Legal Business Name): OHIO VALLEY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 E MARKET ST STE 2
CADIZ OH
43907-8721
US

IV. Provider business mailing address

780 E MARKET ST STE 2
CADIZ OH
43907-8721
US

V. Phone/Fax

Practice location:
  • Phone: 740-320-4008
  • Fax:
Mailing address:
  • Phone: 740-320-4008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KURT SMITH
Title or Position: OWNER
Credential:
Phone: 740-320-4008