MEDICARE: DR. CHERNOH MAJU BAH PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	OH03131950	OH

General Provider Information

NPI Number	:	1134759368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERNOH MAJU BAH PHARMD

Provider Business Mailing Address
First Line	:	7671 HUNTSMAN LN
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-1180
Country	:	US
Telephone Number	:	513-646-4375
Fax Number	:

Provider Business Practice Location Address
First Line	:	5420 LIBERTY FAIRFIELD RD
Second Line	:
City	:	LIBERTY TWP
State	:	OH
Zip	:	45011-2680
Country	:	US
Telephone Number	:	513-785-7920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2020
Last Update Date	:	01/15/2020

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