MEDICARE: DR. LAKEN LISETTE BARNETTE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03442210	OH

General Provider Information

NPI Number	:	1548981590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAKEN LISETTE BARNETTE PHARMD

Provider Business Mailing Address
First Line	:	4155 HAYDEN LOFTS PL APT 116
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-7557
Country	:	US
Telephone Number	:	419-302-5554
Fax Number	:

Provider Business Practice Location Address
First Line	:	4777 SAWMILL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-6160
Country	:	US
Telephone Number	:	614-459-7641
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	09/08/2022

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