Samuel Beyene
Individual provider Active NPI Pharmacist · Moraine, OH
NPI 1033712864 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1033712864
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03237285 (OH)
- Practice address
- 2657 W Alex Bell Rd
Moraine, OH 45459-1121 - Phone
- (937) 298-5512
- NPI assigned
- Nov 16, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03237285 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio CVS Stores, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03237285 | OH | Yes |
Addresses
Primary practice location
2657 W Alex Bell Rd
Moraine, OH 45459-1121
Mailing address
2657 W Alex Bell Rd
Moraine, OH 45459-1121
Phone (937) 298-5512
Other providers in Moraine, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.