Healthcare Provider Details

I. General information

NPI: 1528304276
Provider Name (Legal Business Name): JANET HABEDANK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2012
Last Update Date: 12/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

V. Phone/Fax

Practice location:
  • Phone: 513-862-1703
  • Fax: 513-862-7084
Mailing address:
  • Phone: 513-862-1703
  • Fax: 513-862-7084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03222997
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: