Healthcare Provider Details

I. General information

NPI: 1396674818
Provider Name (Legal Business Name): KYRIE ELEYSON R BADEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 E SPRING VALLEY PIKE STE B
DAYTON OH
45458-4365
US

IV. Provider business mailing address

6695 GREELEY AVE
DAYTON OH
45424-1828
US

V. Phone/Fax

Practice location:
  • Phone: 703-268-8710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03444514
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: