Ronald S. Lukasik II – Pharmacist in Waterville, OH

Key facts

NPI: 1114151966
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 03222970 (OH)
Practice address: 1330 Michigan Ave
Waterville, OH 43566-1011
Phone: (419) 878-8384
Fax: (419) 878-5820
NPI assigned: May 8, 2009
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
03222970	OH	MD	Pharmacist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	03222970	OH	Yes

Addresses

Primary practice location

1330 Michigan Ave
Waterville, OH 43566-1011

Mailing address

1330 Michigan Ave
Waterville, OH 43566-1011
Phone (419) 878-8384

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 8, 2009.

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241740800000",
    "number": "1114151966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 MICHIGAN AVE",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435661011",
            "telephone_number": "419-878-8384",
            "fax_number": "419-878-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 MICHIGAN AVE",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435661011",
            "telephone_number": "419-878-8384",
            "fax_number": "419-878-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKASIK",
        "first_name": "RONALD",
        "middle_name": "S.",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-08",
        "last_updated": "2009-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03222970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, OH

All providers in Waterville, OH · Pharmacist in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.