Healthcare Provider Details

I. General information

NPI: 1821873738
Provider Name (Legal Business Name): ALICIA BRUNEMANN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 08/29/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 MAIN ST
HAMILTON OH
45013
US

IV. Provider business mailing address

305 WOLF TRCE
AMELIA OH
45102-1760
US

V. Phone/Fax

Practice location:
  • Phone: 513-645-5447
  • Fax:
Mailing address:
  • Phone: 513-544-8961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03443283
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: