Provider Demographics
NPI:1023385218
Name:LEMASTER, LONNIE (RPH)
Entity type:Individual
Prefix:MR
First Name:LONNIE
Middle Name:
Last Name:LEMASTER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W BENNETT AVE
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-5179
Mailing Address - Country:US
Mailing Address - Phone:712-325-0619
Mailing Address - Fax:
Practice Address - Street 1:301 W BENNETT AVE
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-5179
Practice Address - Country:US
Practice Address - Phone:712-325-0619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19007183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist