Provider Demographics
NPI:1770156325
Name:WELCH, OLIVIA (RPH)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 S MAIN ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OH
Mailing Address - Zip Code:45810-1599
Mailing Address - Country:US
Mailing Address - Phone:419-722-3784
Mailing Address - Fax:
Practice Address - Street 1:525 S MAIN ST UNIT 1
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OH
Practice Address - Zip Code:45810-1599
Practice Address - Country:US
Practice Address - Phone:419-722-3784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist