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General NPI Number Information
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NPI Number | 1902233174
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Entity Type | Individual
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Provider Name | LUKAS EVERLY PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2013
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 13207 RAVENNA RD
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City | CHARDON
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State | OH
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Zip | 44024-7032
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Country | US
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Telephone | 330-285-6237
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Fax | 440-285-6369
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Provider Business Mailing Address
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Address Line | 10833 RAVENNA RD APT 105
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City | TWINSBURG
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State | OH
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Zip | 44087-2726
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03233008
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License Number State | OH
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