Provider Demographics
NPI:1750531455
Name:VIRGIN, LAWRENCE P (RPH)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:P
Last Name:VIRGIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:PATRICK
Other - Middle Name:
Other - Last Name:VIRGIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:815 CLEPPER LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1535
Mailing Address - Country:US
Mailing Address - Phone:513-753-9280
Mailing Address - Fax:513-753-9287
Practice Address - Street 1:815 CLEPPER LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1535
Practice Address - Country:US
Practice Address - Phone:513-753-9280
Practice Address - Fax:513-753-9287
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03122518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist