Healthcare Provider Details

I. General information

NPI: 1043678238
Provider Name (Legal Business Name): ALEX MATTHEW KLINGENBECK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10477 HARRISON AVE
HARRISON OH
45030-1995
US

IV. Provider business mailing address

10477 HARRISON AVE
HARRISON OH
45030-1995
US

V. Phone/Fax

Practice location:
  • Phone: 513-367-2382
  • Fax: 513-367-2373
Mailing address:
  • Phone: 513-367-2382
  • Fax: 513-367-2373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03334423
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number017749
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: