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General NPI Number Information
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NPI Number | 1770210247
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Entity Type | Individual
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Provider Name | RYAN LANSER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 1670 STARLITE DR
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City | OWENSBORO
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State | KY
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Zip | 42301-3339
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Country | US
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Telephone | 270-926-2340
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Fax |
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Provider Business Mailing Address
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Address Line | 3750 RALPH AVE APT 1023
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City | OWENSBORO
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State | KY
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Zip | 42303-2474
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Country | US
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Telephone | 928-379-0102
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 022952
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License Number State | KY
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