Provider Demographics
NPI:1255784229
Name:WAJERT, JONATHAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:WAJERT
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 1:6765 TOWERING RIDGE WAY
Mailing Address - Street 2:APT. 209
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-4201
Mailing Address - Country:US
Mailing Address - Phone:419-439-2112
Mailing Address - Fax:
Practice Address - Street 1:630 EATON AVE
Practice Address - Street 2:PHARMACY
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2767
Practice Address - Country:US
Practice Address - Phone:513-867-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH.03233950-2183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist