Provider Demographics
NPI:1508042573
Name:LUTES, ANNETTE
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:
Last Name:LUTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8264 W STATE ROUTE 41
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45318-1248
Mailing Address - Country:US
Mailing Address - Phone:800-232-4239
Mailing Address - Fax:
Practice Address - Street 1:8264 W STATE ROUTE 41
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:OH
Practice Address - Zip Code:45318-1248
Practice Address - Country:US
Practice Address - Phone:800-232-4239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03320248183500000X
IN26016000A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist