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General NPI Number Information
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NPI Number | 1336768605
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Entity Type | Individual
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Provider Name | JONATHAN ALEXANDER TRAWICK PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 04/15/2020
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Provider Practice Location Address
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Address Line | 1515 N MADISON AVE
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City | ANDERSON
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State | IN
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Zip | 46011-3457
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Country | US
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Telephone | 765-298-2409
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Fax |
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Provider Business Mailing Address
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Address Line | 12876 COURAGE XING
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City | FISHERS
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State | IN
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Zip | 46037-5995
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Country | US
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Telephone | 251-458-1730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26027668A
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License Number State | IN
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