Healthcare Provider Details

I. General information

NPI: 1215423116
Provider Name (Legal Business Name): KATLYN PRITCHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 RICHMOND RD
WARRENSVILLE HEIGHTS OH
44128-5757
US

IV. Provider business mailing address

7528 LAKE RD
MADISON OH
44057-1624
US

V. Phone/Fax

Practice location:
  • Phone: 216-930-6154
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number03337369
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: