Healthcare Provider Details

I. General information

NPI: 1780766584
Provider Name (Legal Business Name): POHLMAN PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6722 STATE ROUTE 132
GOSHEN OH
45122-9249
US

IV. Provider business mailing address

PO BOX 268
GOSHEN OH
45122-0268
US

V. Phone/Fax

Practice location:
  • Phone: 513-722-3784
  • Fax: 513-722-3786
Mailing address:
  • Phone:
  • Fax: 513-722-3786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number020337800
License Number StateOH

VIII. Authorized Official

Name: JOSEPH MCAUILLIFFE
Title or Position: PRES
Credential:
Phone: 513-722-3784