Provider Demographics
NPI:1679573133
Name:LINEBARGER, TRACY G (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:G
Last Name:LINEBARGER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 CHELSEA AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2523
Mailing Address - Country:US
Mailing Address - Phone:614-235-0784
Mailing Address - Fax:
Practice Address - Street 1:1400 PARSONS AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-3645
Practice Address - Country:US
Practice Address - Phone:614-449-9399
Practice Address - Fax:614-449-8050
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-26567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist