Healthcare Provider Details

I. General information

NPI: 1790769420
Provider Name (Legal Business Name): R L LEWIS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 N 4TH ST
TORONTO OH
43964-1510
US

IV. Provider business mailing address

302 N 4TH ST
TORONTO OH
43964-1510
US

V. Phone/Fax

Practice location:
  • Phone: 740-537-2100
  • Fax: 740-537-1187
Mailing address:
  • Phone: 740-537-2100
  • Fax: 740-537-1187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateOH

VIII. Authorized Official

Name: ROGER LEWIS
Title or Position: OWNER/PHARMACIST
Credential: R.PH.
Phone: 740-537-2100