Healthcare Provider Details

I. General information

NPI: 1437683042
Provider Name (Legal Business Name): MATTHEW LEWANDOWSKI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 10/24/2020
Certification Date: 10/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 W ALEXIS RD
TOLEDO OH
43612-4303
US

IV. Provider business mailing address

3566 INDIAN RD
OTTAWA HILLS OH
43606-2424
US

V. Phone/Fax

Practice location:
  • Phone: 419-269-6909
  • Fax: 419-269-6911
Mailing address:
  • Phone: 440-823-3088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03226443
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03226443
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: