Healthcare Provider Details

I. General information

NPI: 1467665224
Provider Name (Legal Business Name): AFSHIN AZIMI TALEGHANI PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 11/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5229 MONTGOMERY RD
CINCINNATI OH
45212-1602
US

IV. Provider business mailing address

PO BOX 36076
CINCINNATI OH
45236-0076
US

V. Phone/Fax

Practice location:
  • Phone: 513-731-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number06-0-06324
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: