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General NPI Number Information
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NPI Number | 1598213605
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Entity Type | Individual
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Provider Name | LAURA PAWLIK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/17/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 4410 W CACTUS RD
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City | GLENDALE
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State | AZ
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Zip | 85304-2338
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Country | US
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Telephone | 608-938-5087
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Fax |
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Provider Business Mailing Address
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Address Line | 4410 W CACTUS RD
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City | GLENDALE
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State | AZ
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Zip | 85304-2338
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Country | US
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Telephone | 608-938-5087
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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 | 051.299847
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S022193
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License Number State | AZ
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