Provider Demographics
NPI:1437668183
Name:OHIO NORTHERN UNIVERSITY
Entity Type:Organization
Organization Name:OHIO NORTHERN UNIVERSITY
Other - Org Name:ONU HEALTHWISE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF PHARMACY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTGERDES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:419-772-2659
Mailing Address - Street 1:525 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OH
Mailing Address - Zip Code:45810-6000
Mailing Address - Country:US
Mailing Address - Phone:419-772-3784
Mailing Address - Fax:419-772-3783
Practice Address - Street 1:511 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OH
Practice Address - Zip Code:45810
Practice Address - Country:US
Practice Address - Phone:419-772-3784
Practice Address - Fax:419-772-3783
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OH0228167503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy