Healthcare Provider Details

I. General information

NPI: 1114282993
Provider Name (Legal Business Name): JESSICA E LAUBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2012
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4533 MONROE ST
TOLEDO OH
43613-4700
US

IV. Provider business mailing address

2952 CYPRESS COLONY DR
TOLEDO OH
43617-1876
US

V. Phone/Fax

Practice location:
  • Phone: 419-471-9240
  • Fax:
Mailing address:
  • Phone: 248-310-6359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302038820
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302038820
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: