Provider Demographics
NPI:1790769420
Name:R L LEWIS CORP
Entity Type:Organization
Organization Name:R L LEWIS CORP
Other - Org Name:TORONTO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:740-537-2100
Mailing Address - Street 1:302 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:OH
Mailing Address - Zip Code:43964-1510
Mailing Address - Country:US
Mailing Address - Phone:740-537-2100
Mailing Address - Fax:740-537-1187
Practice Address - Street 1:302 N 4TH ST
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:OH
Practice Address - Zip Code:43964-1510
Practice Address - Country:US
Practice Address - Phone:740-537-2100
Practice Address - Fax:740-537-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3652814OtherNCPD
OH0797053Medicaid
OH=========00OtherWORKERS COMP
OH0218190001Medicare ID - Type Unspecified