Healthcare Provider Details

I. General information

NPI: 1629897533
Provider Name (Legal Business Name): ANGELA PEOPLES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4623 WESLEY AVE STE N
CINCINNATI OH
45212-2272
US

IV. Provider business mailing address

4623 WESLEY AVE STE N
CINCINNATI OH
45212-2272
US

V. Phone/Fax

Practice location:
  • Phone: 513-563-6071
  • Fax: 833-347-5635
Mailing address:
  • Phone: 513-569-6071
  • Fax: 833-347-5635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number03-2-21544
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03-2-21544
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: