Provider Demographics
NPI:1073169686
Name:PAINCHAUD, CHRISTOPHER ANDRE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANDRE
Last Name:PAINCHAUD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 VENTNOR CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-3088
Mailing Address - Country:US
Mailing Address - Phone:734-323-6676
Mailing Address - Fax:
Practice Address - Street 1:8405 SOUTHEASTERN AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-1348
Practice Address - Country:US
Practice Address - Phone:317-862-2414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-11
Last Update Date:2019-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26025909A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist