Provider Demographics
NPI:1710356340
Name:KIRK, LAUREN A (PHARMD, BCACP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:KIRK
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:DIBENEDETTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, BCACP
Mailing Address - Street 1:3900 STONERIDGE LN STE B
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2289
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3900 STONERIDGE LN STE B
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017
Practice Address - Country:US
Practice Address - Phone:954-608-8871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-24
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032336761835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist