Healthcare Provider Details

I. General information

NPI: 1801565114
Provider Name (Legal Business Name): COURTNEY COFFMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 HIGHLAND AVE
CINCINNATI OH
45219-2399
US

IV. Provider business mailing address

3130 HIGHLAND AVE
CINCINNATI OH
45219-2399
US

V. Phone/Fax

Practice location:
  • Phone: 513-292-8052
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number03439660
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: