Provider Demographics
NPI:1275097511
Name:LUCE, LAUREN (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:LUCE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:MACKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:1011 RIVER HILLS RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45430-1123
Mailing Address - Country:US
Mailing Address - Phone:248-996-2739
Mailing Address - Fax:
Practice Address - Street 1:106 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CARLISLE
Practice Address - State:OH
Practice Address - Zip Code:45344-1835
Practice Address - Country:US
Practice Address - Phone:937-667-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031358531835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03135853OtherPHARMACIST LICENSE NUMBER