Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
May 1, 2017
License(s)
03227738 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 19471 LAKE DR | Trimble, OH 45782-2508 | 740-767-3851 |
| MAILING | 1735 PUMP STATION RD | Sugar Grove, OH 43155-9709 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.