Provider Demographics
NPI:1902124894
Name:LAKEW, YAMROTE (RPH RN)
Entity Type:Individual
Prefix:MRS
First Name:YAMROTE
Middle Name:
Last Name:LAKEW
Suffix:
Gender:F
Credentials:RPH RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2833 BRYN MAWR DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8915
Mailing Address - Country:US
Mailing Address - Phone:614-598-3001
Mailing Address - Fax:740-879-3240
Practice Address - Street 1:900 COSHOCTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1908
Practice Address - Country:US
Practice Address - Phone:740-397-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03225040-2183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist