Healthcare Provider Details

I. General information

NPI: 1679400139
Provider Name (Legal Business Name): CHRIS STAMATAKOS PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 E TOWNE CENTER BLVD
MAINEVILLE OH
45039-7734
US

IV. Provider business mailing address

148 E TOWNE CENTER BLVD
MAINEVILLE OH
45039-7734
US

V. Phone/Fax

Practice location:
  • Phone: 513-494-2215
  • Fax: 513-494-2539
Mailing address:
  • Phone: 513-494-2215
  • Fax: 513-494-2539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03334686
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: