Provider Demographics
NPI:1851500631
Name:HASEMEIER, GARY BRIAN (RPH)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:BRIAN
Last Name:HASEMEIER
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 1:6033 GLENNBURY CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-4924
Mailing Address - Country:US
Mailing Address - Phone:513-777-5224
Mailing Address - Fax:513-677-1646
Practice Address - Street 1:8872 COLUMBIA RD.
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039
Practice Address - Country:US
Practice Address - Phone:513-677-1264
Practice Address - Fax:513-677-1264
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-12765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03-2-12765OtherPHARMACIST