MEDICARE: MRS. LYNN M MOHR R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03-1-14874	OH

General Provider Information

NPI Number	:	1598742181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNN M MOHR R.PH.

Provider Business Mailing Address
First Line	:	6526 BURDETT RD
Second Line	:
City	:	WADSWORTH
State	:	OH
Zip	:	44281-9719
Country	:	US
Telephone Number	:	330-239-2430
Fax Number	:

Provider Business Practice Location Address
First Line	:	9056 CENTER ST
Second Line	:
City	:	SEVILLE
State	:	OH
Zip	:	44273-8854
Country	:	US
Telephone Number	:	300-769-2995
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	08/14/2012

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