Provider Demographics
NPI:1255428751
Name:PRECISIONRX SPECIALTY SOLUTIONS
Entity type:Organization
Organization Name:PRECISIONRX SPECIALTY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-336-2061
Mailing Address - Street 1:8990 DUKE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8943
Mailing Address - Country:US
Mailing Address - Phone:513-336-4439
Mailing Address - Fax:
Practice Address - Street 1:8990 DUKE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-8943
Practice Address - Country:US
Practice Address - Phone:513-336-4439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHBA9256238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4645070001Medicare ID - Type Unspecified