Provider Demographics
NPI:1871196659
Name:TEKAMP, TAYLOR JO (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JO
Last Name:TEKAMP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4840 GLENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-4402
Mailing Address - Country:US
Mailing Address - Phone:513-921-0831
Mailing Address - Fax:513-921-0103
Practice Address - Street 1:4840 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-4402
Practice Address - Country:US
Practice Address - Phone:513-921-0831
Practice Address - Fax:513-921-0103
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03439799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist