Healthcare Provider Details

I. General information

NPI: 1518419050
Provider Name (Legal Business Name): OBED ASIEDU PHARMD,AAHIVP,BCACP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2016
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 S PATTERSON BLVD
DAYTON OH
45402-2684
US

IV. Provider business mailing address

4865 DIXIE HWY
FAIRFIELD OH
45014-1932
US

V. Phone/Fax

Practice location:
  • Phone: 937-424-1440
  • Fax:
Mailing address:
  • Phone: 800-417-1072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number016144
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03132219
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: