Provider Demographics
NPI:1386824647
Name:DAY HEIGHTS PHARMACY LLC
Entity Type:Organization
Organization Name:DAY HEIGHTS PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:NOLL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-831-0333
Mailing Address - Street 1:5656 WOLFPEN-PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150
Mailing Address - Country:US
Mailing Address - Phone:513-831-0333
Mailing Address - Fax:513-831-0704
Practice Address - Street 1:5656 WOLFPEN PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150
Practice Address - Country:US
Practice Address - Phone:513-831-0333
Practice Address - Fax:513-831-6444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021736400332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2802784Medicaid
3676472OtherOTHER ID NUMBER