Healthcare Provider Details

I. General information

NPI: 1013799543
Provider Name (Legal Business Name): MARY ANTYPAS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6235 MONROE ST
SYLVANIA OH
43560-1427
US

IV. Provider business mailing address

6455 MONROE ST APT 229
SYLVANIA OH
43560-1463
US

V. Phone/Fax

Practice location:
  • Phone: 419-885-4738
  • Fax: 419-824-9701
Mailing address:
  • Phone: 419-779-3430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03443770
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: