Provider Demographics
NPI:1841628740
Name:MOLNAR, TRUDY (RPH)
Entity type:Individual
Prefix:
First Name:TRUDY
Middle Name:
Last Name:MOLNAR
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 1:301 VINEWOOD OVAL
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-3138
Mailing Address - Country:US
Mailing Address - Phone:440-263-5671
Mailing Address - Fax:
Practice Address - Street 1:4020 MILAN RD
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5892
Practice Address - Country:US
Practice Address - Phone:419-609-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03219473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist