Healthcare Provider Details

I. General information

NPI: 1245315134
Provider Name (Legal Business Name): ERIN PUENING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 06/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3760 PAXTON AVE
CINCINNATI OH
45209-2306
US

IV. Provider business mailing address

3760 PAXTON AVE
CINCINNATI OH
45209-2306
US

V. Phone/Fax

Practice location:
  • Phone: 513-871-0725
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-27306
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03127306
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: