| Doctor Name: | MRS. MARY E LEWALLEN |
| NPI Number: | 1518931096 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.PH.T |
| License Number: | 20285 |
| Business Practice Address: | 18157 Alberta St Oneida, TN - 378416201 |
| Business Phone Number: | 4235695555 |
| Business Fax Number: | 4235698805 |
| Mailing Address: | 421 Coffee Dr, HELENWOOD |
| State: | TN |
| Postal Code: | 377555318 |
| Phone Number: | 4232868312 |
| Fax Number: | |
| NPI Enumeration Date: | 02/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 183700000X |
| License Number: | 20285 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacy Technician |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |