Basic Information
Provider Information
NPI: 1407809221
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEST
FirstName: JULIE
MiddleName: D
NamePrefix: MRS.
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 17273 STATE ROUTE 104
Address2:  
City: CHILLICOTHE
State: OH
PostalCode: 456018608
CountryCode: US
TelephoneNumber: 7407731141
FaxNumber: 7407727151
Practice Location
Address1: 17273 STATE ROUTE 104
Address2:  
City: CHILLICOTHE
State: OH
PostalCode: 456018608
CountryCode: US
TelephoneNumber: 7407731141
FaxNumber: 7407727151
Other Information
ProviderEnumerationDate: 05/19/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XRP045640LPAY Pharmacy Service ProvidersPharmacist 

No ID Information.


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