Provider Demographics
NPI:1962770073
Name:SOMERLOT, CASEY LEAH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:LEAH
Last Name:SOMERLOT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:CASEY
Other - Middle Name:LEAH
Other - Last Name:COWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:OH
Mailing Address - Zip Code:43320-0013
Mailing Address - Country:US
Mailing Address - Phone:419-560-4741
Mailing Address - Fax:
Practice Address - Street 1:1075 ASHLAND RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905-2156
Practice Address - Country:US
Practice Address - Phone:419-589-8843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-03
Last Update Date:2011-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03331034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist