Provider Demographics
NPI:1477178481
Name:SUMMA, DEANNA LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:LYNN
Last Name:SUMMA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 MILL CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-6438
Mailing Address - Country:US
Mailing Address - Phone:937-728-2508
Mailing Address - Fax:
Practice Address - Street 1:1040 POLARIS PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-2291
Practice Address - Country:US
Practice Address - Phone:614-781-1037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031358833336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy