Provider Demographics
NPI:1457725178
Name:MENNE, BRETT (RPH)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:MENNE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 MADONNA DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2655
Mailing Address - Country:US
Mailing Address - Phone:859-468-7821
Mailing Address - Fax:
Practice Address - Street 1:4825 MARBURG AVE UNIT A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-5013
Practice Address - Country:US
Practice Address - Phone:513-631-5717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03335004183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist