Provider Demographics
NPI:1245600824
Name:MAKAREWICZ, KATHLEEN LINNEA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:LINNEA
Last Name:MAKAREWICZ
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 1:8077 MARIGOLA DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-5526
Mailing Address - Country:US
Mailing Address - Phone:916-939-3969
Mailing Address - Fax:
Practice Address - Street 1:8077 MARIGOLA DR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-5526
Practice Address - Country:US
Practice Address - Phone:916-939-3969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist