Jeanelle Rene Lucas, PHARMD
Individual provider Active NPI Pharmacist · Plain City, OH
NPI 1306341276 · NPPES record last updated Mar 24, 2018
Key facts
- NPI
- 1306341276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03328819 (OH)
- Practice address
- 7300 State Route 161 E
Plain City, OH 43064-9276 - Phone
- (614) 733-5012
- NPI assigned
- Mar 24, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03328819 | OH | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03328819 | OH | Yes |
Addresses
Primary practice location
7300 State Route 161 E
Plain City, OH 43064-9276
Mailing address
12185 Andrews Dr
Plain City, OH 43064-9148
Phone (248) 459-9455
Other providers in Plain City, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.