Provider Demographics
NPI:1093313728
Name:LANCE, SHARON ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:LANCE
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 1:5511 SAINT PETERS WAY
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-1783
Mailing Address - Country:US
Mailing Address - Phone:440-773-7432
Mailing Address - Fax:
Practice Address - Street 1:9040 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6464
Practice Address - Country:US
Practice Address - Phone:440-255-9159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032178473336C0003X
NC294433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy