Healthcare Provider Details

I. General information

NPI: 1700370970
Provider Name (Legal Business Name): JULIE MAY LENNON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2639
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-2534
  • Fax: 614-722-2710
Mailing address:
  • Phone: 614-722-2406
  • Fax: 614-722-2710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03215446
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: