Provider Demographics
NPI:1053703413
Name:HART, PETER J (RPH)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:J
Last Name:HART
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 HAMPTON POINTE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-1537
Mailing Address - Country:US
Mailing Address - Phone:513-741-9240
Mailing Address - Fax:513-741-7968
Practice Address - Street 1:4525 HAMPTON POINTE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-1537
Practice Address - Country:US
Practice Address - Phone:513-741-9240
Practice Address - Fax:513-741-7968
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-17426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist