Healthcare Provider Details

I. General information

NPI: 1366929705
Provider Name (Legal Business Name): BROOKE ESPENSCHIED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 07/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 N JAMES RD
COLUMBUS OH
43219-1834
US

IV. Provider business mailing address

8660 CARTER RD
HILLIARD OH
43026-8321
US

V. Phone/Fax

Practice location:
  • Phone: 614-388-7547
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03337566
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: