Provider Demographics
NPI:1427380765
Name:PAJONK, SUSAN (RPH)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:PAJONK
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 1:4545 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-2033
Mailing Address - Country:US
Mailing Address - Phone:317-328-0401
Mailing Address - Fax:317-328-0401
Practice Address - Street 1:4545 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254
Practice Address - Country:US
Practice Address - Phone:317-328-0401
Practice Address - Fax:317-328-0401
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016094A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist