Provider Demographics
NPI:1205439890
Name:MAYER, JONATHAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:MAYER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7314 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4002
Mailing Address - Country:US
Mailing Address - Phone:513-686-7771
Mailing Address - Fax:513-891-6041
Practice Address - Street 1:7314 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4002
Practice Address - Country:US
Practice Address - Phone:513-686-7771
Practice Address - Fax:513-891-6041
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03328801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist