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General NPI Number Information
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NPI Number | 1750981692
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Entity Type | Individual
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Provider Name | ANNA GREEN
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Gender | Female
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Dates
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Enumeration Date | 10/29/2020
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 815 CLEPPER LN
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City | CINCINNATI
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State | OH
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Zip | 45245-1535
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Country | US
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Telephone | 513-753-9280
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Fax | 513-753-9287
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Provider Business Mailing Address
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Address Line | 5 MARLENE DR
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City | WILLIAMSBURG
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State | OH
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Zip | 45176-9364
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Country | US
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Telephone | 513-313-6836
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 019469
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03236980
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License Number State | OH
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