MEDICARE: DIANA LEE SZYMANSKI RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03221112	OH

General Provider Information

NPI Number	:	1316477300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA LEE SZYMANSKI RPH

Provider Business Mailing Address
First Line	:	27322 CARRONADE DR
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-3368
Country	:	US
Telephone Number	:	567-336-4659
Fax Number	:	567-336-4661

Provider Business Practice Location Address
First Line	:	27322 CARRONADE DR
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-3368
Country	:	US
Telephone Number	:	567-336-4659
Fax Number	:	567-336-4661

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2017
Last Update Date	:	07/21/2022

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