Provider Demographics
NPI:1134506439
Name:GERLACH, LAURA SUE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:SUE
Last Name:GERLACH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:05432 DICKE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BREMEN
Mailing Address - State:OH
Mailing Address - Zip Code:45869-9750
Mailing Address - Country:US
Mailing Address - Phone:614-943-4760
Mailing Address - Fax:
Practice Address - Street 1:05432 DICKE RD
Practice Address - Street 2:
Practice Address - City:NEW BREMEN
Practice Address - State:OH
Practice Address - Zip Code:45869-9750
Practice Address - Country:US
Practice Address - Phone:614-943-4760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03328746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist