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NPI Code Detail

MEDICARE: NATHAN HERRELL PHARMD

MEDICARE: NATHAN HERRELL 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
1183500000XPharmacist03443222OH

General Provider Information

NPI Number : 1750143186
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN HERRELL PHARMD
Provider Business Mailing Address
First Line : 9851 FORESTGLEN DR
Second Line :
City : MONTGOMERY
State : OH
Zip : 45242-5936
Country : US
Telephone Number : 513-417-0650
Fax Number :
Provider Business Practice Location Address
First Line : 9546 MONTGOMERY RD
Second Line :
City : MONTGOMERY
State : OH
Zip : 45242-7220
Country : US
Telephone Number : 513-793-4451
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2024
Last Update Date : 01/30/2024

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