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General NPI Number Information
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NPI Number | 1306468327
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Entity Type | Individual
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Provider Name | LARA PAYNE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/13/2020
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 4361 IRWIN SIMPSON RD
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City | MASON
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State | OH
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Zip | 45040-9479
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Country | US
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Telephone | 513-204-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 3583 CREEK XING
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City | AMELIA
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State | OH
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Zip | 45102-1764
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Country | US
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Telephone | 513-720-9078
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 031275611
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License Number State | OH
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