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General NPI Number Information
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NPI Number | 1043738693
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Entity Type | Individual
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Provider Name | ANDREA ENTERLINE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 09/05/2017
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Provider Practice Location Address
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Address Line | 230 NORTH MAIN STREET
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City | DAYTON
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State | OH
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Zip | 45402
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Country | US
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Telephone | 937-224-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 2815 WOODSVIEW DR APT 2
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City | BEAVERCREEK
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State | OH
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Zip | 45431-7715
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03237100
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License Number State | OH
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