Provider Demographics
NPI:1598742181
Name:MOHR, LYNN M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:M
Last Name:MOHR
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 1:6526 BURDETT RD
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9719
Mailing Address - Country:US
Mailing Address - Phone:330-239-2430
Mailing Address - Fax:
Practice Address - Street 1:9056 CENTER ST
Practice Address - Street 2:
Practice Address - City:SEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44273-8854
Practice Address - Country:US
Practice Address - Phone:300-769-2995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-14874183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist