Healthcare Provider Details

I. General information

NPI: 1356269567
Provider Name (Legal Business Name): CHARITY GOTTFRIED PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2600 NAVARRE AVE
OREGON OH
43616-3207
US

IV. Provider business mailing address

637 S SANDUSKY ST
TIFFIN OH
44883-2642
US

V. Phone/Fax

Practice location:
  • Phone: 419-696-7595
  • Fax:
Mailing address:
  • Phone: 419-560-5037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03446893
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: