Provider Demographics
NPI:1942660766
Name:LENGEL, MATTHEW (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:LENGEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 E LONG ST
Mailing Address - Street 2:APT 702
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2914
Mailing Address - Country:US
Mailing Address - Phone:419-213-0783
Mailing Address - Fax:
Practice Address - Street 1:8 E LONG ST
Practice Address - Street 2:APT 702
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2914
Practice Address - Country:US
Practice Address - Phone:419-213-0783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03234128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist