Healthcare Provider Details
I. General information
NPI: 1558397810
Provider Name (Legal Business Name): MICHAEL ALLEN HEGENER PHARMD, BCACP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/25/2006
Last Update Date: 05/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
UNIVERSITY OF CINCINNATI COLLEGE OF PHARMACY 3225 EDEN AVENUE
CINCINNATI OH
45267-0004
US
IV. Provider business mailing address
UNIVERSITY OF CINCINNATI COLLEGE OF PHARMACY 3225 EDEN AVENUE
CINCINNATI OH
45267-0004
US
V. Phone/Fax
- Phone: 513-558-7806
- Fax:
- Phone: 513-558-7806
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 012892 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: