Healthcare Provider Details

I. General information

NPI: 1215219639
Provider Name (Legal Business Name): LEAH HURLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 09/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W CORRY ST
CINCINNATI OH
45219-3901
US

IV. Provider business mailing address

3931 GRAND AVE
CINCINNATI OH
45236-3909
US

V. Phone/Fax

Practice location:
  • Phone: 513-652-9583
  • Fax:
Mailing address:
  • Phone: 513-652-9583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03331139
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: