Provider Demographics
NPI:1164904785
Name:ZDANEK, CATHERINE (RPH)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:ZDANEK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2964 HALL AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-4827
Mailing Address - Country:US
Mailing Address - Phone:304-266-8998
Mailing Address - Fax:
Practice Address - Street 1:1412 GRAND AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3808
Practice Address - Country:US
Practice Address - Phone:970-945-7403
Practice Address - Fax:970-945-9697
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0010548183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist