Provider Demographics
NPI:1598369225
Name:PUGH, CHRISTIAN MICHAEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:MICHAEL
Last Name:PUGH
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 1:430 ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-1103
Mailing Address - Country:US
Mailing Address - Phone:937-770-1114
Mailing Address - Fax:
Practice Address - Street 1:430 ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309-1103
Practice Address - Country:US
Practice Address - Phone:937-770-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03439452183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist