Provider Demographics
NPI:1376147850
Name:SPRINGMYER, TODD RAYMOND
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:RAYMOND
Last Name:SPRINGMYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CHEVIOT
Mailing Address - State:OH
Mailing Address - Zip Code:45211-4557
Mailing Address - Country:US
Mailing Address - Phone:513-574-1770
Mailing Address - Fax:513-574-6764
Practice Address - Street 1:4110 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CHEVIOT
Practice Address - State:OH
Practice Address - Zip Code:45211-4557
Practice Address - Country:US
Practice Address - Phone:513-574-1770
Practice Address - Fax:513-574-6764
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03114813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist