Provider Demographics
NPI:1851872246
Name:VUCUREVICH, AMY N
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:N
Last Name:VUCUREVICH
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 1:9203 TERWILLIGERS WOOD CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-2754
Mailing Address - Country:US
Mailing Address - Phone:304-573-3789
Mailing Address - Fax:
Practice Address - Street 1:9997 CARVER RD
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-5537
Practice Address - Country:US
Practice Address - Phone:304-573-3789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03135409183500000X
KY018784183500000X
TN0000041752183500000X
NC25701183500000X
WVRP0008599183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist