MEDICARE: KYRIE ELEYSON R BADEN 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	183500000X	Pharmacist	03444514	OH

General Provider Information

NPI Number	:	1396674818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYRIE ELEYSON R BADEN PHARMD

Provider Business Mailing Address
First Line	:	6695 GREELEY AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45424-1828
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 E SPRING VALLEY PIKE STE B
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-4365
Country	:	US
Telephone Number	:	703-268-8710
Fax Number	:

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

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/21/2026

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