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NPI Code Detail

MEDICARE: KAYLA A HETRICK PHARMD

MEDICARE: KAYLA A HETRICK PHARMD
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
1183500000XPharmacist5302042655MI
21835C0205XCritical Care Pharmacist5302042655MI
31835C0205XCritical Care Pharmacist03136303OH

General Provider Information

NPI Number : 1750996922
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA A HETRICK PHARMD
Provider Business Mailing Address
First Line : 10148 HIGHLAND DR
Second Line :
City : BRECKSVILLE
State : OH
Zip : 44141-3327
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-308-4051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2020
Last Update Date : 09/14/2020

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Directions to “ KAYLA A HETRICK PHARMD” Practice Location

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