Provider Demographics
NPI:1841871431
Name:WARD, TRACY ANN (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:ANN
Last Name:WARD
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5890 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2200
Mailing Address - Country:US
Mailing Address - Phone:141-990-2470
Mailing Address - Fax:
Practice Address - Street 1:5890 MONROE ST
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2200
Practice Address - Country:US
Practice Address - Phone:419-824-6213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09200463183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician