Healthcare Provider Details

I. General information

NPI: 1750015707
Provider Name (Legal Business Name): ELIZABETH BIRTHELMER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2022
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10335 S MEDALLION DR
CINCINNATI OH
45241-4825
US

IV. Provider business mailing address

1513 SPECTACULAR BID CT
LEBANON OH
45036-8178
US

V. Phone/Fax

Practice location:
  • Phone: 513-739-6345
  • Fax:
Mailing address:
  • Phone: 513-739-6345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number03440230
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: