Provider Demographics
NPI:1467983916
Name:BASINGER, DEBRA LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:BASINGER
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 1:1355 N LEXINGTON SPRINGMILL RD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1126
Mailing Address - Country:US
Mailing Address - Phone:419-747-8310
Mailing Address - Fax:
Practice Address - Street 1:1355 N LEXINGTON SPRINGMILL RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-1126
Practice Address - Country:US
Practice Address - Phone:419-747-8310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03321795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist