Provider Demographics
NPI:1578232120
Name:OHIO INTAKE PHARMACY 2 LLC
Entity type:Organization
Organization Name:OHIO INTAKE PHARMACY 2 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:GREENALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-860-2534
Mailing Address - Street 1:6 S 2ND ST STE 506
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-2846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 S 2ND ST STE 506
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-2846
Practice Address - Country:US
Practice Address - Phone:513-737-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy