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NPI Code Detail

MEDICARE: LEAH FULLER PHARMD, RPH

MEDICARE: LEAH FULLER PHARMD, 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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist03129739OH
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist014706KY

General Provider Information

NPI Number : 1235423583
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH FULLER PHARMD, RPH
Provider Business Mailing Address
First Line : 5830 HARRISON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-1623
Country : US
Telephone Number : 513-574-5044
Fax Number :
Provider Business Practice Location Address
First Line : 5830 HARRISON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-1623
Country : US
Telephone Number : 513-574-5044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2011
Last Update Date : 06/03/2011

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