Provider Demographics
NPI:1841232881
Name:GERTH, BRIAN EDWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:EDWARD
Last Name:GERTH
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 1:548 ELBERON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45205-2302
Mailing Address - Country:US
Mailing Address - Phone:513-251-2947
Mailing Address - Fax:513-899-3783
Practice Address - Street 1:43 W FOSTER MAINEVILLE RD
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-9662
Practice Address - Country:US
Practice Address - Phone:513-683-5300
Practice Address - Fax:513-683-4049
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-14914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist