Healthcare Provider Details

I. General information

NPI: 1548177009
Provider Name (Legal Business Name): SARAH ELIZABETH LYSINGER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 PORTLAND WAY S
GALION OH
44833-2312
US

IV. Provider business mailing address

91 WALNUT ST
SHELBY OH
44875-1562
US

V. Phone/Fax

Practice location:
  • Phone: 419-468-4841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03446809
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: