Doctor Name: | MRS. LAURIE ANN BOHLER |
NPI Number: | 1003057324 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPHT |
License Number: | 180106834480059 |
Business Practice Address: | 2104 Massey Ave Branch Medical Clinic Nas Mayport Jacksonville, FL - 32224 |
Business Phone Number: | 9042704205 |
Business Fax Number: | 9042704454 |
Mailing Address: | 244 Otterwood Ct, JACKSONVILLE |
State: | FL |
Postal Code: | 322253900 |
Phone Number: | 9042200459 |
Fax Number: | 9042200459 |
NPI Enumeration Date: | 03/17/2009 |
NPI Last Update Date: | 03/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 183700000X |
License Number: | 180106834480059 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacy Technician |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |