Healthcare Provider Details

I. General information

NPI: 1477005155
Provider Name (Legal Business Name): PHILLIP PAUVLINCH PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 N HIGH ST
COLUMBUS OH
43201-2409
US

IV. Provider business mailing address

945 INGLESIDE AVE
COLUMBUS OH
43215-1283
US

V. Phone/Fax

Practice location:
  • Phone: 614-340-6776
  • Fax: 614-340-6774
Mailing address:
  • Phone: 724-622-8076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03132065
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: