Healthcare Provider Details

I. General information

NPI: 1861859530
Provider Name (Legal Business Name): JONATHAN TERRY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3195 GEIER DR
CINCINNATI OH
45209-5009
US

IV. Provider business mailing address

3195 GEIER DR
CINCINNATI OH
45209-5009
US

V. Phone/Fax

Practice location:
  • Phone: 513-458-2410
  • Fax: 513-458-2465
Mailing address:
  • Phone: 513-458-2410
  • Fax: 513-458-2465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number023282
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03334829
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26026060A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: