Provider Demographics
NPI:1508889247
Name:SIER INC
Entity Type:Organization
Organization Name:SIER INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:P
Authorized Official - Last Name:SIER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:937-433-1321
Mailing Address - Street 1:205 N MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459
Mailing Address - Country:US
Mailing Address - Phone:937-433-1321
Mailing Address - Fax:937-433-0495
Practice Address - Street 1:205 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459
Practice Address - Country:US
Practice Address - Phone:937-433-1321
Practice Address - Fax:937-433-0495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3611870OtherNCPDP #
OH2001336Medicaid
OH2001336Medicaid
OH3611870OtherNCPDP #