Provider Demographics
NPI:1487708236
Name:DURHAM, LAURA MICHELLE (RPH)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MICHELLE
Last Name:DURHAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 HAGEMAN CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45176-9549
Mailing Address - Country:US
Mailing Address - Phone:513-724-5652
Mailing Address - Fax:
Practice Address - Street 1:7110 BACHMAN RD
Practice Address - Street 2:
Practice Address - City:SARDINIA
Practice Address - State:OH
Practice Address - Zip Code:45171-9456
Practice Address - Country:US
Practice Address - Phone:937-446-2545
Practice Address - Fax:937-446-2600
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-22524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist