Healthcare Provider Details

I. General information

NPI: 1568462430
Provider Name (Legal Business Name): DENISE LYNN CONWAY R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 E MAIN ST
DANVILLE OH
43014-9807
US

IV. Provider business mailing address

18787 BAKER RD
MOUNT VERNON OH
43050-9586
US

V. Phone/Fax

Practice location:
  • Phone: 740-481-2300
  • Fax: 740-481-3019
Mailing address:
  • Phone: 740-397-1420
  • Fax: 740-397-2454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24190
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: