Provider Demographics
NPI:1568043693
Name:CONAWAY, ASHLEY LYNN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:CONAWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W ROBB AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-2745
Mailing Address - Country:US
Mailing Address - Phone:419-229-5846
Mailing Address - Fax:
Practice Address - Street 1:302 W ROBB AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-2745
Practice Address - Country:US
Practice Address - Phone:419-229-5846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09203603183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician