Healthcare Provider Details
I. General information
NPI: 1770878308
Provider Name (Legal Business Name): JAMES MATTHEW EADY MD, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/11/2011
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 BURNET AVE
CINCINNATI OH
45229-3026
US
IV. Provider business mailing address
3333 BURNET AVE
CINCINNATI OH
45229-3026
US
V. Phone/Fax
- Phone: 615-681-6877
- Fax:
- Phone: 615-681-6877
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 010504 |
| License Number State | MS |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 35.153081 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: