Healthcare Provider Details

I. General information

NPI: 1811514490
Provider Name (Legal Business Name): ANDREW GEBHART
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8241 VINE ST
CINCINNATI OH
45216-1461
US

IV. Provider business mailing address

8241 VINE ST
CINCINNATI OH
45216-1461
US

V. Phone/Fax

Practice location:
  • Phone: 513-821-9660
  • Fax: 513-821-5307
Mailing address:
  • Phone: 513-821-9660
  • Fax: 513-821-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03439750
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: