Provider Demographics
NPI:1205123817
Name:HITE, JENNIFER DIANE (PHARMD, RPH)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:DIANE
Last Name:HITE
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 1:3600 SOLDANO BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-1458
Mailing Address - Country:US
Mailing Address - Phone:614-274-8108
Mailing Address - Fax:
Practice Address - Street 1:3600 SOLDANO BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1458
Practice Address - Country:US
Practice Address - Phone:614-274-8108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-03
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03230094183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist