Provider Demographics
NPI:1073896668
Name:MITCHELL, JAMIE L (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 MIAMISBURG CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-3802
Mailing Address - Country:US
Mailing Address - Phone:937-291-2741
Mailing Address - Fax:937-291-2840
Practice Address - Street 1:1402 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3802
Practice Address - Country:US
Practice Address - Phone:937-291-2741
Practice Address - Fax:937-291-2840
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH . 03331003183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist