Provider Demographics
NPI:1750467825
Name:CHRISTIAN, JOSEPH SAMUEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:SAMUEL
Last Name:CHRISTIAN
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 1:6125 N MULBERRY GROVE RAKESTR RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45318-8878
Mailing Address - Country:US
Mailing Address - Phone:937-473-5119
Mailing Address - Fax:937-473-5119
Practice Address - Street 1:8264 W STATE ROUTE 41
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:OH
Practice Address - Zip Code:45318-1248
Practice Address - Country:US
Practice Address - Phone:937-473-3333
Practice Address - Fax:937-473-3000
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-17988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist