Provider Demographics
NPI:1801229596
Name:MANU, BERNICE A (MBA, PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:BERNICE
Middle Name:A
Last Name:MANU
Suffix:
Gender:F
Credentials:MBA, PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 OAK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-7913
Mailing Address - Country:US
Mailing Address - Phone:513-288-0104
Mailing Address - Fax:
Practice Address - Street 1:830 OAK FOREST DR
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-7913
Practice Address - Country:US
Practice Address - Phone:513-288-0104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist