Provider Demographics
NPI:1831209097
Name:LOONEY, LINDA CAROL (RPH)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:CAROL
Last Name:LOONEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 WILLOWDALE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502-9001
Mailing Address - Country:US
Mailing Address - Phone:937-964-8037
Mailing Address - Fax:
Practice Address - Street 1:512 S BURNETT RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-2720
Practice Address - Country:US
Practice Address - Phone:937-328-6654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-17142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist