Provider Demographics
NPI:1194847608
Name:ENGELHARDT, HOLLY (RPH)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:ENGELHARDT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 CITATION LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OH
Mailing Address - Zip Code:45052-9782
Mailing Address - Country:US
Mailing Address - Phone:513-941-0181
Mailing Address - Fax:
Practice Address - Street 1:5053 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3903
Practice Address - Country:US
Practice Address - Phone:513-471-7575
Practice Address - Fax:513-471-1443
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-21307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist