Healthcare Provider Details

I. General information

NPI: 1245964188
Provider Name (Legal Business Name): EMMA SIEGEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2022
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 MIAMI CHAPEL RD
DAYTON OH
45417-4650
US

IV. Provider business mailing address

5689 SALEM RD
CINCINNATI OH
45230-2721
US

V. Phone/Fax

Practice location:
  • Phone: 937-281-6800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number03442198
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: