Healthcare Provider Details

I. General information

NPI: 1689886756
Provider Name (Legal Business Name): RICHARD LEE ARENDS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST PHARMACY DEPARTMENT
DAYTON OH
45409-2722
US

IV. Provider business mailing address

4239 AUTUMN CREEK DR
SPRINGFIELD OH
45504-5110
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-3195
  • Fax:
Mailing address:
  • Phone: 937-390-2058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03-2-13703
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: