Provider Demographics
NPI:1154322170
Name:HERBSTER, WALTER ANDREW (RPH, MBA)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:ANDREW
Last Name:HERBSTER
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4659 FARCREST CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-6914
Mailing Address - Country:US
Mailing Address - Phone:513-535-2568
Mailing Address - Fax:513-385-1072
Practice Address - Street 1:5403 N BEND RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-7620
Practice Address - Country:US
Practice Address - Phone:513-662-1541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-16832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist