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General NPI Number Information
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NPI Number | 1205581337
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Entity Type | Individual
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Provider Name | HABIB MARIO ABRAHAM PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 1701 MERCY HEALTH PL
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City | CINCINNATI
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State | OH
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Zip | 45237-6147
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Country | US
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Telephone | 513-952-4443
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Fax |
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Provider Business Mailing Address
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Address Line | 7754 ALBRIGHT CT
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City | MASON
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State | OH
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Zip | 45040-8886
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Country | US
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Telephone | 513-884-2242
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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 | 3336M0003X
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Taxonomy Name | Managed Care Organization Pharmacy
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License Number | 03230596
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License Number State | OH
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