Provider Demographics
NPI:1447675947
Name:HART, MICHELLE (RPH)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 EASTGATE NORTH DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1588
Mailing Address - Country:US
Mailing Address - Phone:513-943-5733
Mailing Address - Fax:513-943-5765
Practice Address - Street 1:888 EASTGATE NORTH DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1588
Practice Address - Country:US
Practice Address - Phone:513-943-5733
Practice Address - Fax:513-943-5765
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03127608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist