Healthcare Provider Details

I. General information

NPI: 1962391094
Provider Name (Legal Business Name): MATTHEW WILLIAM BOHLANDER PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3086 MADISON RD
CINCINNATI OH
45209-1723
US

IV. Provider business mailing address

1668 HICKORY THICKET DR
MILFORD OH
45150-9785
US

V. Phone/Fax

Practice location:
  • Phone: 513-321-9980
  • Fax:
Mailing address:
  • Phone: 513-430-5597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03445454
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: