Provider Demographics
NPI:1083085799
Name:LAWLOR, RENNAE O'NEILL (RPH)
Entity Type:Individual
Prefix:
First Name:RENNAE
Middle Name:O'NEILL
Last Name:LAWLOR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 COASTAL HWY
Mailing Address - Street 2:UNIT 1806
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-2559
Mailing Address - Country:US
Mailing Address - Phone:609-868-7875
Mailing Address - Fax:
Practice Address - Street 1:10700 COASTAL HWY
Practice Address - Street 2:UNIT 1806
Practice Address - City:OCEAN CITY
Practice Address - State:MD
Practice Address - Zip Code:21842-2559
Practice Address - Country:US
Practice Address - Phone:609-868-7875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18833183500000X
PARP033691L183500000X
DEA1-0004025183500000X
NJ28RI01793800183500000X
NC20027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist