Provider Demographics
NPI:1336674720
Name:BOLLINGER, SAMANTHA LEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:LEIGH
Last Name:BOLLINGER
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 1:4656 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1298
Mailing Address - Country:US
Mailing Address - Phone:614-876-1248
Mailing Address - Fax:614-334-0277
Practice Address - Street 1:4656 CEMETERY RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1298
Practice Address - Country:US
Practice Address - Phone:614-876-1248
Practice Address - Fax:614-334-0277
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03129658183500000X
KY014666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist