Provider Demographics
NPI:1043767502
Name:VIRTUS OHIO PHARMACY LLC
Entity Type:Organization
Organization Name:VIRTUS OHIO PHARMACY LLC
Other - Org Name:HANNAH NEIL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEXLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-435-5751
Mailing Address - Street 1:9352 DAYTON LEBANON PIKE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3843
Mailing Address - Country:US
Mailing Address - Phone:937-435-5751
Mailing Address - Fax:937-435-5759
Practice Address - Street 1:301 OBETZ RD
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-4036
Practice Address - Country:US
Practice Address - Phone:937-435-5751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2163966OtherPK