Healthcare Provider Details

I. General information

NPI: 1831591387
Provider Name (Legal Business Name): LINDSAY RYDER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W 10TH AVE 368 DOAN HALL
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

410 W 10TH AVE 368 DOAN HALL
COLUMBUS OH
43210-1240
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-0698
  • Fax:
Mailing address:
  • Phone: 614-293-0698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03224860
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: