Healthcare Provider Details

I. General information

NPI: 1154322170
Provider Name (Legal Business Name): WALTER ANDREW HERBSTER RPH, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5403 N BEND RD
CINCINNATI OH
45247-7620
US

IV. Provider business mailing address

4659 FARCREST CT
CINCINNATI OH
45247-6914
US

V. Phone/Fax

Practice location:
  • Phone: 513-662-1541
  • Fax:
Mailing address:
  • Phone: 513-535-2568
  • Fax: 513-385-1072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-16832
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: