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General NPI Number Information
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NPI Number | 1164024006
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Entity Type | Individual
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Provider Name | CASSADIE SIMONE BAKER RPH, PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 272 HOSPITAL RD
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-9031
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Country | US
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Telephone | 740-779-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 2565 LONDON GROVEPORT RD
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City | GROVE CITY
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State | OH
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Zip | 43123-9844
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Country | US
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Telephone | 614-277-2921
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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 | 03440634
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License Number State | OH
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