Healthcare Provider Details

I. General information

NPI: 1407891625
Provider Name (Legal Business Name): SAMARITAN PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 PHILADELPHIA DR
DAYTON OH
45406-1813
US

IV. Provider business mailing address

2222 PHILADELPHIA DR
DAYTON OH
45406-1813
US

V. Phone/Fax

Practice location:
  • Phone: 937-274-1546
  • Fax: 937-276-8229
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROSEMARY HAUBERT
Title or Position: PHARMACIST
Credential:
Phone: 937-274-1546