Provider Demographics
NPI:1790845063
Name:WEISENBERGER, CHRISTINA A (RPH)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
Last Name:WEISENBERGER
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 1:1712 EDISON AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-4408
Mailing Address - Country:US
Mailing Address - Phone:513-844-6679
Mailing Address - Fax:
Practice Address - Street 1:640 WESSEL DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-3600
Practice Address - Country:US
Practice Address - Phone:513-868-6397
Practice Address - Fax:513-868-9786
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03122510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist