MEDICARE: DR. KATHERINE BLAZEK PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835C0205X	Critical Care Pharmacist	03237566	OH

General Provider Information

NPI Number	:	1023609229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE BLAZEK PHARMD

Provider Business Mailing Address
First Line	:	1425 PRIMROSE DR
Second Line	:
City	:	SEVEN HILLS
State	:	OH
Zip	:	44131-3057
Country	:	US
Telephone Number	:	269-569-1027
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0002
Country	:	US
Telephone Number	:	216-337-5378
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2021
Last Update Date	:	01/30/2021

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