Provider Demographics
NPI:1932531043
Name:LARKIN, ALYSSA RAE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:RAE
Last Name:LARKIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 S UNION AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4951
Mailing Address - Country:US
Mailing Address - Phone:330-829-3782
Mailing Address - Fax:
Practice Address - Street 1:2012 S UNION AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4951
Practice Address - Country:US
Practice Address - Phone:330-829-3782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03232601183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist