Provider Demographics
NPI:1073737342
Name:LEWIS, DUSTIN G (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:G
Last Name:LEWIS
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13613 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45123-9723
Mailing Address - Country:US
Mailing Address - Phone:937-283-9725
Mailing Address - Fax:937-283-9818
Practice Address - Street 1:610 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2125
Practice Address - Country:US
Practice Address - Phone:937-283-9725
Practice Address - Fax:937-283-9818
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03227944183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist