Provider Demographics
NPI:1356752083
Name:DAVIDSON, JILL (RPH)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-6800
Mailing Address - Country:US
Mailing Address - Phone:513-598-2010
Mailing Address - Fax:513-598-2065
Practice Address - Street 1:6550 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-6800
Practice Address - Country:US
Practice Address - Phone:513-598-2010
Practice Address - Fax:513-598-2065
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03124785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist