Provider Demographics
NPI:1184225088
Name:LAMMERS, CRYSTAL (RPH)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:LAMMERS
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 1:38990 AMBERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4743
Mailing Address - Country:US
Mailing Address - Phone:440-225-7767
Mailing Address - Fax:
Practice Address - Street 1:1000 CHESTNUT COMMONS DR
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-9602
Practice Address - Country:US
Practice Address - Phone:440-366-0125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03225232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist