Healthcare Provider Details

I. General information

NPI: 1811510639
Provider Name (Legal Business Name): MAEGAN NICHOLE KLOSTERMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7747 OLD TROY PIKE
DAYTON OH
45424-2085
US

IV. Provider business mailing address

14242 PROVIDENCE PIKE
BROOKVILLE OH
45309-9709
US

V. Phone/Fax

Practice location:
  • Phone: 937-233-7680
  • Fax:
Mailing address:
  • Phone: 937-901-5791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03233138
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: