Healthcare Provider Details

I. General information

NPI: 1649067851
Provider Name (Legal Business Name): OHIO INTAKE PHARMACY 3 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 S 2ND ST STE 400
HAMILTON OH
45011-2846
US

IV. Provider business mailing address

6 S 2ND ST STE 400
HAMILTON OH
45011-2846
US

V. Phone/Fax

Practice location:
  • Phone: 513-443-5679
  • Fax: 513-323-6130
Mailing address:
  • Phone: 513-443-5679
  • Fax: 513-323-6130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PAUL GREENALL
Title or Position: MANAGER
Credential:
Phone: 513-443-5679