Organization
LIBERTY TOWNSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANETTE L CLARY (FISCAL OFFICER)
(740) 701-5503
Entity
Organization
Contact information
Practice address
34568 US HIGHWAY 50, LONDONDERRY, OH 45647-9772
(740) 887-4515
Mailing address
PO BOX 151, LONDONDERRY, OH 45647-0151
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020719700
BOARD OF PHARMACY
—
Enumeration date
08/31/2015
Last updated
05/15/2023
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