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General NPI Number Information
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NPI Number | 1649874173
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Entity Type | Individual
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Provider Name | AMY LAUREN BACH
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Gender | Female
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Dates
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Enumeration Date | 11/25/2020
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 1137 STATE ROUTE 131
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City | MILFORD
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State | OH
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Zip | 45150-2715
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Country | US
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Telephone | 513-831-8225
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Fax | 513-831-9259
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Provider Business Mailing Address
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Address Line | 1137 STATE ROUTE 131
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City | MILFORD
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State | OH
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Zip | 45150-2715
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Country | US
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Telephone | 513-831-8225
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Fax | 513-831-9259
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03120552
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License Number State | OH
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