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General NPI Number Information
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NPI Number | 1568856276
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Entity Type | Organization
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Legal Business Name | NORTHMARK PHARMACY LLC
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 1945 CEI DR
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City | BLUE ASH
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State | OH
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Zip | 45242-5664
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Country | US
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Telephone | 513-984-5133
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 CEI DR
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City | BLUE ASH
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State | OH
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Zip | 45242-5664
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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 | MANAGER
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Name | TODD ALBERTZ
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Credential |
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Telephone | 513-569-3702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 022247900-03
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License Number State | OH
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