Provider Demographics
NPI:1922608561
Name:EARLY, CHAD MICHAEL
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:MICHAEL
Last Name:EARLY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-1442
Mailing Address - Country:US
Mailing Address - Phone:937-840-0136
Mailing Address - Fax:937-840-0348
Practice Address - Street 1:119 S HIGH ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-1442
Practice Address - Country:US
Practice Address - Phone:937-840-0136
Practice Address - Fax:937-840-0348
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032305651835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist