Healthcare Provider Details

I. General information

NPI: 1457709719
Provider Name (Legal Business Name): CHARLES SEHLHORST RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 W MARKET ST SUITE 200
LIMA OH
45805-2796
US

IV. Provider business mailing address

803 W MARKET ST SUITE 200
LIMA OH
45805-2796
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-2752
  • Fax: 419-996-5040
Mailing address:
  • Phone: 419-996-2752
  • Fax: 419-996-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number03221296
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: