Provider Demographics
NPI:1437683042
Name:LEWANDOWSKI, MATTHEW (RPH)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:LEWANDOWSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3566 INDIAN RD
Mailing Address - Street 2:
Mailing Address - City:OTTAWA HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:43606-2424
Mailing Address - Country:US
Mailing Address - Phone:440-823-3088
Mailing Address - Fax:
Practice Address - Street 1:833 W ALEXIS RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-4303
Practice Address - Country:US
Practice Address - Phone:419-269-6909
Practice Address - Fax:419-269-6911
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032264431835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist