Healthcare Provider Details

I. General information

NPI: 1629694070
Provider Name (Legal Business Name): KEVIN BISHER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2020
Last Update Date: 06/22/2020
Certification Date: 06/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 MONTGOMERY RD
CINCINNATI OH
45212-2607
US

IV. Provider business mailing address

4605 MONTGOMERY RD
CINCINNATI OH
45212-2607
US

V. Phone/Fax

Practice location:
  • Phone: 513-731-0062
  • Fax: 513-731-7520
Mailing address:
  • Phone: 513-731-0062
  • Fax: 513-731-7520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-3-37280
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: