Provider Demographics
NPI:1083012827
Name:LAWRENCE MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:LAWRENCE MEMORIAL HOSPITAL
Other - Org Name:LMH HEALTH SYSTEM PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:VIXEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEINES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, BCPS
Authorized Official - Phone:785-505-2245
Mailing Address - Street 1:325 MAINE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1360
Mailing Address - Country:US
Mailing Address - Phone:785-505-2240
Mailing Address - Fax:785-505-6417
Practice Address - Street 1:325 MAINE ST STE 250
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1360
Practice Address - Country:US
Practice Address - Phone:785-505-2240
Practice Address - Fax:785-505-6417
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAWRENCE MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-10
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy