Provider Demographics
NPI:1730843137
Name:SAWMAN, LISA ELLEN (RPH)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ELLEN
Last Name:SAWMAN
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 1:3335 POSSUM RUN RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-7509
Mailing Address - Country:US
Mailing Address - Phone:419-564-1921
Mailing Address - Fax:
Practice Address - Street 1:4014 VENTURE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-9600
Practice Address - Country:US
Practice Address - Phone:614-297-8244
Practice Address - Fax:859-303-9224
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032163831835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03216383OtherPHARMACY LICENSE