Provider Demographics
NPI:1063792547
Name:BIEDENHARN, MELISSA (RPH)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BIEDENHARN
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 1:1032 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-1522
Mailing Address - Country:US
Mailing Address - Phone:513-367-2127
Mailing Address - Fax:513-367-9516
Practice Address - Street 1:1032 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-1522
Practice Address - Country:US
Practice Address - Phone:513-367-2127
Practice Address - Fax:513-367-9516
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-28
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03320038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist