Active NPI
Ciara Latavia Dickerson
- Pharmacy Technician
- Holland, OH
National Provider Identifier
1639865454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- TW130834
- Practice address
- 7225 Airport Hwy
Holland, OH 43528-7829 - Phone
- (419) 866-8943
- NPI assigned
- Apr 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | TW130834 | OH | Primary |
Addresses
Primary practice location
7225 Airport Hwy
Holland, OH 43528-7829
Mailing address
7225 Airport Hwy
Holland, OH 43528-7829
Phone (419) 866-8943
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TW130834 | OH | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lane Drug Co | Past | Accepting new patients | |
| Lane Drug Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681430400000",
"number": "1639865454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7225 AIRPORT HWY",
"city": "HOLLAND",
"state": "OH",
"postal_code": "435287829",
"telephone_number": "419-866-8943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7225 AIRPORT HWY",
"city": "HOLLAND",
"state": "OH",
"postal_code": "435287829",
"telephone_number": "419-866-8943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "CIARA",
"middle_name": "LATAVIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-14",
"last_updated": "2023-04-14",
"certification_date": "2023-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "OH",
"license": "TW130834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.