Healthcare Provider Details

I. General information

NPI: 1174185037
Provider Name (Legal Business Name): BARBARA HOERSTEN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 07/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 W WAYNE ST
PAULDING OH
45879-9235
US

IV. Provider business mailing address

1035 W WAYNE ST
PAULDING OH
45879-9235
US

V. Phone/Fax

Practice location:
  • Phone: 419-399-4080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03223076
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: