Healthcare Provider Details

I. General information

NPI: 1326021098
Provider Name (Legal Business Name): DANIEL RAYMOND BEHRENS PHARM.D., R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 N POINT DR
MOUNT ORAB OH
45154-8366
US

IV. Provider business mailing address

PO BOX 794
OXFORD OH
45056-0794
US

V. Phone/Fax

Practice location:
  • Phone: 937-444-0133
  • Fax: 937-444-1442
Mailing address:
  • Phone: 937-444-0133
  • Fax: 937-444-1442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-19310
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: