Provider Demographics
NPI:1275855082
Name:TORDAI, PAULA KAY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:KAY
Last Name:TORDAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:PAULA
Other - Middle Name:KAY-TORDAI
Other - Last Name:MEYERMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5635 BUCKHORN LANE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52802
Mailing Address - Country:US
Mailing Address - Phone:563-370-2602
Mailing Address - Fax:
Practice Address - Street 1:1150 W CARL SANDBURG DR
Practice Address - Street 2:KMART PHARMACY
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-1387
Practice Address - Country:US
Practice Address - Phone:309-344-3088
Practice Address - Fax:309-344-3154
Is Sole Proprietor?:No
Enumeration Date:2010-02-20
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20177183500000X
IL051290780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist