Healthcare Provider Details

I. General information

NPI: 1336418201
Provider Name (Legal Business Name): WILLIAM C STITH PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 STATE RD
CINCINNATI OH
45255-2439
US

IV. Provider business mailing address

7500 STATE RD
CINCINNATI OH
45255-2439
US

V. Phone/Fax

Practice location:
  • Phone: 513-624-4668
  • Fax: 513-624-4820
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03331373
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number015562
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: