Provider Demographics
NPI:1174828057
Name:MCMASTER, LINDA RENEE
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:RENEE
Last Name:MCMASTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7733 DARCY DR
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-8108
Mailing Address - Country:US
Mailing Address - Phone:330-331-4828
Mailing Address - Fax:
Practice Address - Street 1:1114 W HIGH ST
Practice Address - Street 2:
Practice Address - City:ORRVILLE
Practice Address - State:OH
Practice Address - Zip Code:44667-1438
Practice Address - Country:US
Practice Address - Phone:330-683-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03118986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist