Provider Demographics
NPI:1851023212
Name:LOMENICK, LAUREN ABIGAIL (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ABIGAIL
Last Name:LOMENICK
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 1:37 COUNTY ROAD 140
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-6119
Mailing Address - Country:US
Mailing Address - Phone:662-279-5333
Mailing Address - Fax:
Practice Address - Street 1:203 N NEWBURGER AVE
Practice Address - Street 2:
Practice Address - City:BRUCE
Practice Address - State:MS
Practice Address - Zip Code:38915-9430
Practice Address - Country:US
Practice Address - Phone:662-983-4011
Practice Address - Fax:662-983-4072
Is Sole Proprietor?:No
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-100710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist