Provider Demographics
NPI:1053899419
Name:FREEMAN, CASSAUNDRA S (PHARMD)
Entity type:Individual
Prefix:
First Name:CASSAUNDRA
Middle Name:S
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CASSAUNDRA
Other - Middle Name:S
Other - Last Name:GROOMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:920 ALEXANDERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3988
Mailing Address - Country:US
Mailing Address - Phone:513-509-0314
Mailing Address - Fax:
Practice Address - Street 1:962 S DORSET RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-4705
Practice Address - Country:US
Practice Address - Phone:855-772-2725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-29
Last Update Date:2018-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202216254183500000X
OH03236832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist