Provider Demographics
NPI:1073831483
Name:BASINGER, STEVEN MICHAEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MICHAEL
Last Name:BASINGER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 EASTVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1910
Mailing Address - Country:US
Mailing Address - Phone:800-643-5523
Mailing Address - Fax:800-533-7114
Practice Address - Street 1:1750 HIGHLAND RD
Practice Address - Street 2:SUITE 1
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-2275
Practice Address - Country:US
Practice Address - Phone:800-643-5523
Practice Address - Fax:800-533-7114
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03124232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist