Provider Demographics
NPI:1558388108
Name:JEFFREY P. BIDDLE INC.
Entity Type:Organization
Organization Name:JEFFREY P. BIDDLE INC.
Other - Org Name:VILLAGE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:BIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-367-4836
Mailing Address - Street 1:114 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-1328
Mailing Address - Country:US
Mailing Address - Phone:513-367-4836
Mailing Address - Fax:513-367-4837
Practice Address - Street 1:114 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-1328
Practice Address - Country:US
Practice Address - Phone:513-367-4836
Practice Address - Fax:513-367-4837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0722758Medicaid
3615359OtherNCPDP