Provider Demographics
NPI:1447582663
Name:LUKAS, LANCE (RPH)
Entity Type:Individual
Prefix:MR
First Name:LANCE
Middle Name:
Last Name:LUKAS
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 1:1304 NORTHWOODS DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-8217
Mailing Address - Country:US
Mailing Address - Phone:937-393-3352
Mailing Address - Fax:
Practice Address - Street 1:1249 N HIGH ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-8274
Practice Address - Country:US
Practice Address - Phone:937-393-8438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03114980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist