=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770624314
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEFFREY D. HILL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2007
-----------------------------------------------------
Last Update Date | 06/19/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 931 STATE ROUTE 28 SUITE 205
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45150-4918
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-831-8211
-----------------------------------------------------
Fax | 513-831-2419
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 931 STATE ROUTE 28 SUITE 205
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45150-4918
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-831-8211
-----------------------------------------------------
Fax | 513-831-2419
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JEFFREY DAVID HILL
-----------------------------------------------------
Credential | R.PH.
-----------------------------------------------------
Telephone | 513-831-8211
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 020450000
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------