Healthcare Provider Details

I. General information

NPI: 1851902076
Provider Name (Legal Business Name): AMY K BOHMAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 S MAIN ST
CENTERVILLE OH
45458-3840
US

IV. Provider business mailing address

7534 STONE RIDGE DR
SPRINGBORO OH
45066-9087
US

V. Phone/Fax

Practice location:
  • Phone: 937-439-6420
  • Fax: 937-439-6455
Mailing address:
  • Phone: 937-750-6133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03320953
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: