Provider Demographics
NPI:1972712610
Name:HEITZMAN, STEVEN LAWRENCE (RPH)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:LAWRENCE
Last Name:HEITZMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8876 OXWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9727
Mailing Address - Country:US
Mailing Address - Phone:513-683-9150
Mailing Address - Fax:
Practice Address - Street 1:3911 W STATE ROUTE 22 3
Practice Address - Street 2:MEIJER PHARMACY #150
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-7395
Practice Address - Country:US
Practice Address - Phone:513-583-2133
Practice Address - Fax:513-583-2165
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-23155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist