Provider Demographics
NPI:1376825943
Name:HASHEM, SAMANTHA S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:S
Last Name:HASHEM
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 1:3881 POPLAR BEND DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-5017
Mailing Address - Country:US
Mailing Address - Phone:614-274-1432
Mailing Address - Fax:
Practice Address - Street 1:2110 STRINGTOWN RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2931
Practice Address - Country:US
Practice Address - Phone:614-277-1325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03225107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist