Healthcare Provider Details

I. General information

NPI: 1366009953
Provider Name (Legal Business Name): RACHEL ELIZABETH BRADY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11930 KEMPER SPRINGS DR STE 100
CINCINNATI OH
45240-1642
US

IV. Provider business mailing address

11930 KEMPER SPRINGS DR STE 100
CINCINNATI OH
45240-1642
US

V. Phone/Fax

Practice location:
  • Phone: 513-587-6202
  • Fax:
Mailing address:
  • Phone: 513-587-6202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03443040
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number022855
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: