Provider Demographics
NPI:1053064337
Name:MANIS, CARI ANN
Entity Type:Individual
Prefix:MS
First Name:CARI
Middle Name:ANN
Last Name:MANIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-8127
Mailing Address - Country:US
Mailing Address - Phone:513-532-5011
Mailing Address - Fax:
Practice Address - Street 1:6175 HI TEK CT
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-2603
Practice Address - Country:US
Practice Address - Phone:513-459-7626
Practice Address - Fax:513-459-8278
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03226296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist