Individual provider Active NPI

Brent Anthony Homan, R.PH.

  • Pharmacist
  • Dayton, OH
National Provider Identifier
1134722804
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03226182 Issued in OH
Practice address
32 N Ludlow St
Dayton, OH 45402-1826
Phone
(937) 269-4592
NPI assigned
Nov 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03226182 OH Primary

Addresses

Primary practice location

32 N Ludlow St
Dayton, OH 45402-1826

Mailing address

117 Cardinal St
New Bremen, OH 45869-1042
Phone (937) 269-4592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
03226182OHMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1134722804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CARDINAL ST",
            "city": "NEW BREMEN",
            "state": "OH",
            "postal_code": "458691042",
            "telephone_number": "937-269-4592",
            "fax_number": "401-406-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 N LUDLOW ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454021826",
            "telephone_number": "937-269-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMAN",
        "first_name": "BRENT",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03226182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.