Provider Demographics
NPI:1811589716
Name:MCDOWELL, LAURA EVELYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:EVELYN
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 DEERPATH DR
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-6084
Mailing Address - Country:US
Mailing Address - Phone:419-239-1157
Mailing Address - Fax:
Practice Address - Street 1:1400 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:OH
Practice Address - Zip Code:44811-9088
Practice Address - Country:US
Practice Address - Phone:419-483-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03230159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist