Provider Demographics
NPI:1417349853
Name:FRERICK, JENNIFER (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FRERICK
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5080 DELHI AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-5343
Mailing Address - Country:US
Mailing Address - Phone:513-451-7050
Mailing Address - Fax:513-451-0172
Practice Address - Street 1:5080 DELHI AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-5343
Practice Address - Country:US
Practice Address - Phone:513-451-7050
Practice Address - Fax:513-451-0172
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03331382-3183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist