Provider Demographics
NPI:1033491063
Name:ROPENUS, GAIL LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:LYNN
Last Name:ROPENUS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16909 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1137
Mailing Address - Country:US
Mailing Address - Phone:216-712-6487
Mailing Address - Fax:
Practice Address - Street 1:100 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6138
Practice Address - Country:US
Practice Address - Phone:440-322-7604
Practice Address - Fax:440-322-9035
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03226580183500000X
VA0202205277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist