MEDICARE: HEATHER LYNN LERCHBACHER

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03135782	OH

General Provider Information

NPI Number	:	1538709894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER LYNN LERCHBACHER

Provider Business Mailing Address
First Line	:	2508 WESTMOOR RD
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-2850
Country	:	US
Telephone Number	:	419-672-9816
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 W HIGH ST
Second Line	:
City	:	FOSTORIA
State	:	OH
Zip	:	44830-2134
Country	:	US
Telephone Number	:	419-435-4190
Fax Number	:

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

Provider Enumeration Date	:	01/14/2020
Last Update Date	:	01/14/2020

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