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NPI Code Detail

MEDICARE: DENNIS LEE STALLO

MEDICARE:   DENNIS LEE STALLO
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
1183500000XPharmacist03310612OH

General Provider Information

NPI Number : 1275137572
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS LEE STALLO
Provider Business Mailing Address
First Line : 9925 MCCAULY WOODS DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45241-1492
Country : US
Telephone Number : 513-260-3714
Fax Number :
Provider Business Practice Location Address
First Line : 5229 MONTGOMERY RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-1602
Country : US
Telephone Number : 513-731-2600
Fax Number : 513-731-4618
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2020
Last Update Date : 11/27/2020

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Directions to “ DENNIS LEE STALLO ” Practice Location

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