Healthcare Provider Details

I. General information

NPI: 1861877029
Provider Name (Legal Business Name): SHAUNDA ELIZABETH BERNHARDT CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8680 BEECHMONT AVE
CINCINNATI OH
45255-4710
US

IV. Provider business mailing address

1939 HARKER WAITS RD
WILLIAMSBURG OH
45176-9485
US

V. Phone/Fax

Practice location:
  • Phone: 513-309-0867
  • Fax:
Mailing address:
  • Phone: 513-309-0867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: