Healthcare Provider Details

I. General information

NPI: 1407863087
Provider Name (Legal Business Name): SUSAN ELLEN HOHENSTEIN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W WATER ST
OAK HARBOR OH
43449-1336
US

IV. Provider business mailing address

265 N WOODLAND AVE
CLYDE OH
43410-1411
US

V. Phone/Fax

Practice location:
  • Phone: 419-898-3911
  • Fax:
Mailing address:
  • Phone: 419-908-1563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number020676450
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: