Provider Demographics
NPI:1891065231
Name:STRAIN, LYNN U (RPH)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:U
Last Name:STRAIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:U
Other - Last Name:STRAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:107 ST REGIS DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7939
Mailing Address - Country:US
Mailing Address - Phone:601-270-4186
Mailing Address - Fax:601-952-0192
Practice Address - Street 1:6308 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-2033
Practice Address - Country:US
Practice Address - Phone:601-952-2979
Practice Address - Fax:601-952-0192
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-5897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist