Healthcare Provider Details

I. General information

NPI: 1346402609
Provider Name (Legal Business Name): HARNESS HEALTH PHARMACY - CENTRAL PHARMACY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7160 INDUSTRIAL ROW DR STE 330
MASON OH
45040-1695
US

IV. Provider business mailing address

7160 INDUSTRIAL ROW DR STE 330
MASON OH
45040-1695
US

V. Phone/Fax

Practice location:
  • Phone: 513-557-7650
  • Fax: 513-557-7675
Mailing address:
  • Phone: 513-557-7650
  • Fax: 513-557-7675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberMOP.020030950-03
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY M RALSTON
Title or Position: VP REIMBURSEMENT
Credential:
Phone: 419-996-5119