Provider Demographics
NPI:1275932196
Name:LOEHR, RYAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:LOEHR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:MO
Mailing Address - Zip Code:65355-3431
Mailing Address - Country:US
Mailing Address - Phone:660-438-7331
Mailing Address - Fax:
Practice Address - Street 1:1330 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:MO
Practice Address - Zip Code:65355-3431
Practice Address - Country:US
Practice Address - Phone:660-438-7331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014025406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist