Provider Demographics
NPI:1225351687
Name:BARANOWSKI, JOSEPH M (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:M
Last Name:BARANOWSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 HAMPTON GLEN CT
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-6679
Mailing Address - Country:US
Mailing Address - Phone:704-609-1631
Mailing Address - Fax:
Practice Address - Street 1:9202 LAWYERS RD
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-5144
Practice Address - Country:US
Practice Address - Phone:704-545-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10303183500000X
SCPH12508183500000X
VA0202005664183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist