Healthcare Provider Details

I. General information

NPI: 1619161080
Provider Name (Legal Business Name): KENNETH D HOFFMAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3249 COOPER RD
CINCINNATI OH
45241-3312
US

IV. Provider business mailing address

3249 COOPER RD
CINCINNATI OH
45241-3312
US

V. Phone/Fax

Practice location:
  • Phone: 513-733-9380
  • Fax:
Mailing address:
  • Phone: 513-733-9380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-23697
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: