Active NPI
Naimagbon Etana
- Pharmacist
- Springboro, OH
National Provider Identifier
1457036519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03442979
- Practice address
- 710 N Main St
Springboro, OH 45066-8944 - Phone
- (937) 748-1135
- NPI assigned
- Jun 16, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03442979 | OH | Primary |
Addresses
Primary practice location
710 N Main St
Springboro, OH 45066-8944
Mailing address
7 Muriel CT Apt G
Fairfield, OH 45014-2969
Phone (513) 904-2167
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03442979 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686873600000",
"number": "1457036519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 MURIEL CT APT G",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450142969",
"telephone_number": "513-904-2167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 N MAIN ST",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450668944",
"telephone_number": "937-748-1135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETANA",
"first_name": "NAIMAGBON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-16",
"last_updated": "2023-06-16",
"certification_date": "2023-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03442979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springboro, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.