Healthcare Provider Details

I. General information

NPI: 1851500631
Provider Name (Legal Business Name): GARY BRIAN HASEMEIER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8872 COLUMBIA RD.
MAINEVILLE OH
45039
US

IV. Provider business mailing address

6033 GLENNBURY CT
WEST CHESTER OH
45069-4924
US

V. Phone/Fax

Practice location:
  • Phone: 513-677-1264
  • Fax: 513-677-1264
Mailing address:
  • Phone: 513-777-5224
  • Fax: 513-677-1646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-12765
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: