Provider Demographics
NPI:1861081010
Name:PACETTI, CINDY (RPH)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:PACETTI
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 1:2891 ASHTON DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-8969
Mailing Address - Country:US
Mailing Address - Phone:513-933-0843
Mailing Address - Fax:
Practice Address - Street 1:268 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-1104
Practice Address - Country:US
Practice Address - Phone:937-748-0555
Practice Address - Fax:937-748-3188
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03322053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2162314Medicaid