Healthcare Provider Details

I. General information

NPI: 1417556887
Provider Name (Legal Business Name): LAUREN LEE HULETTE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2020
Last Update Date: 10/18/2020
Certification Date: 10/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 TRI COUNTY PKWY
CINCINNATI OH
45246-3217
US

IV. Provider business mailing address

101 E 4TH ST UNIT 338
NEWPORT KY
41071-3087
US

V. Phone/Fax

Practice location:
  • Phone: 513-782-8405
  • Fax:
Mailing address:
  • Phone: 513-213-1920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03439895
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: