Healthcare Provider Details

I. General information

NPI: 1326332693
Provider Name (Legal Business Name): JEFFREY E CHOATE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2011
Last Update Date: 06/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E KEMPER RD T-1037
SPRINGDALE OH
45246-2518
US

IV. Provider business mailing address

900 E KEMPER RD T-1037
SPRINGDALE OH
45246-2518
US

V. Phone/Fax

Practice location:
  • Phone: 513-671-8603
  • Fax: 513-671-8603
Mailing address:
  • Phone: 513-671-8603
  • Fax: 513-671-8603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03114816
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: