Healthcare Provider Details

I. General information

NPI: 1669196051
Provider Name (Legal Business Name): HAYLEY JAEGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 05/18/2024
Certification Date: 05/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3086 MADISON RD
CINCINNATI OH
45209-1723
US

IV. Provider business mailing address

3086 MADISON RD
CINCINNATI OH
45209-1723
US

V. Phone/Fax

Practice location:
  • Phone: 513-321-9980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03441096
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: