Healthcare Provider Details

I. General information

NPI: 1215329503
Provider Name (Legal Business Name): KWASI AMFO-ANTIRI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1474 HAMILTON RICHMOND RD
HAMILTON OH
45013-1074
US

IV. Provider business mailing address

1474 MAIN ST. HAMILTON
HAMILTON OH
45013
US

V. Phone/Fax

Practice location:
  • Phone: 513-868-6578
  • Fax: 513-868-8056
Mailing address:
  • Phone: 513-868-6578
  • Fax: 513-868-8056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number03129689
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: