MEDICARE: JENNIFER ANNE LAYNE RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	OH03118914	OH

General Provider Information

NPI Number	:	1174169676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ANNE LAYNE RPH

Provider Business Mailing Address
First Line	:	1474 MAIN ST
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-1074
Country	:	US
Telephone Number	:	513-868-6578
Fax Number	:	513-868-8056

Provider Business Practice Location Address
First Line	:	1474 MAIN ST
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-1074
Country	:	US
Telephone Number	:	513-868-6578
Fax Number	:	513-868-8056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2019
Last Update Date	:	06/22/2026

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