=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861916553
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEY JANAE THORBAHN PHARM.D, RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/03/2017
-----------------------------------------------------
Last Update Date | 08/03/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3015 E LIVINGSTON AVE
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43209-3047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-236-8622
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4428 COUNTY ROAD 247
-----------------------------------------------------
City | VICKERY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43464-9768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-547-0795
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 03237042
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------