Provider Demographics
NPI:1346061843
Name:HARDING, MAKAYLA (RPH)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:
Last Name:HARDING
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 1:3131 WYOMING DR
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-4449
Mailing Address - Country:US
Mailing Address - Phone:937-823-9587
Mailing Address - Fax:
Practice Address - Street 1:5400 CORNERSTONE NORTH BLVD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45440-2273
Practice Address - Country:US
Practice Address - Phone:937-528-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03444875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist