Provider Demographics
NPI:1205383916
Name:PACANOVSKY, CATHERINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:PACANOVSKY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4830 KNIGHTSBRIDGE BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4830 KNIGHTSBRIDGE BLVD STE C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2300
Practice Address - Country:US
Practice Address - Phone:614-360-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-10
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03226484-2183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist