Provider Demographics
NPI:1053304584
Name:LADY, ANN LYNN (R PH)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:LYNN
Last Name:LADY
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 LIMERICK CT
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-9024
Mailing Address - Country:US
Mailing Address - Phone:717-220-1102
Mailing Address - Fax:
Practice Address - Street 1:1105 LIMERICK CT
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-9024
Practice Address - Country:US
Practice Address - Phone:717-220-1102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031562L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist