Provider Demographics
NPI:1982011094
Name:JAHAHN, LEAH MAY BIERLEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:MAY BIERLEY
Last Name:JAHAHN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LEAH
Other - Middle Name:MAY
Other - Last Name:BIERLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2929 WALKER NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49544
Mailing Address - Country:US
Mailing Address - Phone:740-681-2410
Mailing Address - Fax:740-681-2465
Practice Address - Street 1:8000 EAST BROAD STREET
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068
Practice Address - Country:US
Practice Address - Phone:614-322-7410
Practice Address - Fax:614-322-7465
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0168545Medicaid