Provider Demographics
NPI:1730662594
Name:HARTLINE, CHRISTY D
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:D
Last Name:HARTLINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 MEDINA RD STE 700
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-9335
Mailing Address - Country:US
Mailing Address - Phone:888-322-6216
Mailing Address - Fax:
Practice Address - Street 1:1113 MEDINA RD STE 700
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-9335
Practice Address - Country:US
Practice Address - Phone:888-322-6216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03338151183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist