Provider Demographics
NPI:1730462003
Name:AWAD, MATTHEW (RPH)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:AWAD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3186 HARRISON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211
Mailing Address - Country:US
Mailing Address - Phone:513-481-3332
Mailing Address - Fax:513-481-8453
Practice Address - Street 1:3186 HARRISON AVENUE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-5641
Practice Address - Country:US
Practice Address - Phone:513-481-3332
Practice Address - Fax:513-481-8453
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH033185201835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy