Provider Demographics
NPI:1740598515
Name:MINEO, E. LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:E.
Middle Name:LYNN
Last Name:MINEO
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 1:2624 TONBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-1217
Mailing Address - Country:US
Mailing Address - Phone:302-475-6787
Mailing Address - Fax:
Practice Address - Street 1:1050 BRANDYWINE PKWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-1492
Practice Address - Country:US
Practice Address - Phone:302-478-3200
Practice Address - Fax:302-478-3200
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA10002378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist