Provider Demographics
NPI:1407125313
Name:CAIN, ANDREW VERNON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:VERNON
Last Name:CAIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 PENTAGON BLVD
Mailing Address - Street 2:INPATIENT PHARMACY
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1705
Mailing Address - Country:US
Mailing Address - Phone:937-702-4770
Mailing Address - Fax:937-702-4779
Practice Address - Street 1:3535 PENTAGON BLVD
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-1705
Practice Address - Country:US
Practice Address - Phone:937-702-4770
Practice Address - Fax:937-702-4779
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03329027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist