Provider Demographics
NPI:1861118762
Name:HIPSHER, MALLORY ANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:MALLORY
Middle Name:ANNE
Last Name:HIPSHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MALLORY
Other - Middle Name:ANNE
Other - Last Name:LLOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:270 COUNTY ROAD 20
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OH
Mailing Address - Zip Code:45810-9424
Mailing Address - Country:US
Mailing Address - Phone:567-674-1726
Mailing Address - Fax:
Practice Address - Street 1:1900 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1216
Practice Address - Country:US
Practice Address - Phone:419-423-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26868183500000X
OH03131704183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist