Healthcare Provider Details

I. General information

NPI: 1164525242
Provider Name (Legal Business Name): ROSE WULLIGER R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3917 SPRING GROVE AVE
CINCINNATI OH
45223-3302
US

IV. Provider business mailing address

3101 BURNET AVE
CINCINNATI OH
45229-3014
US

V. Phone/Fax

Practice location:
  • Phone: 513-357-7600
  • Fax: 513-352-3939
Mailing address:
  • Phone: 513-357-7289
  • Fax: 513-357-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-12446
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: