Healthcare Provider Details

I. General information

NPI: 1801740212
Provider Name (Legal Business Name): EDWARD MOREIRA BAHNSON PHARMD CANDIDATE,PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3255 EDEN AVE KOWALEWSKI HALL
CINCINNATI OH
45267-0001
US

IV. Provider business mailing address

1532 MERRIMAC ST # A
CINCINNATI OH
45207-1739
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-3784
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number060005990
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: