Provider Demographics
NPI:1851537609
Name:LEWANDOWSKI, CRAIG ADAM (RPH)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:ADAM
Last Name:LEWANDOWSKI
Suffix:
Gender:M
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:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-0245
Mailing Address - Country:US
Mailing Address - Phone:304-736-4608
Mailing Address - Fax:
Practice Address - Street 1:78 PERRY WINKLE LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-9506
Practice Address - Country:US
Practice Address - Phone:304-736-4608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005308183500000X
CARPH 39748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist