Healthcare Provider Details

I. General information

NPI: 1013835545
Provider Name (Legal Business Name): NIMIT SHAH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST
DAYTON OH
45409-2722
US

IV. Provider business mailing address

7092 LARKSPUR LN
LIBERTY TOWNSHIP OH
45044-8341
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03443768
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: