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General NPI Number Information
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NPI Number | 1093313728
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Entity Type | Individual
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Provider Name | SHARON ANN LANCE RPH
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Gender | Female
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 9040 MENTOR AVE
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City | MENTOR
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State | OH
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Zip | 44060-6464
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Country | US
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Telephone | 440-255-9159
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Fax |
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Provider Business Mailing Address
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Address Line | 5511 SAINT PETERS WAY
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City | MENTOR
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State | OH
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Zip | 44060-1783
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Country | US
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Telephone | 440-773-7432
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 03217847
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 29443
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License Number State | NC
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