Provider Demographics
NPI:1356941611
Name:BELL, MARY LYNETTE (R PH)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LYNETTE
Last Name:BELL
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:MRS
Other - First Name:LYNETTE
Other - Middle Name:
Other - Last Name:MATTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:R PH
Mailing Address - Street 1:702 SW 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72716-0135
Mailing Address - Country:US
Mailing Address - Phone:800-925-6278
Mailing Address - Fax:330-834-1210
Practice Address - Street 1:1 MASSILLON MARKETPLACE DR
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-2018
Practice Address - Country:US
Practice Address - Phone:330-834-0552
Practice Address - Fax:330-834-1210
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03117529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist