Provider Demographics
NPI:1144829243
Name:CRANE, SUE (RPH)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:CRANE
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 1:6950 MIAMI AVE
Mailing Address - Street 2:
Mailing Address - City:MADEIRA
Mailing Address - State:OH
Mailing Address - Zip Code:45243-2633
Mailing Address - Country:US
Mailing Address - Phone:513-271-1360
Mailing Address - Fax:513-271-4021
Practice Address - Street 1:6950 MIAMI AVE
Practice Address - Street 2:
Practice Address - City:MADEIRA
Practice Address - State:OH
Practice Address - Zip Code:45243-2633
Practice Address - Country:US
Practice Address - Phone:513-271-1360
Practice Address - Fax:513-271-4021
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH033185081835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist