Provider Demographics
NPI:1467458786
Name:COYLE, MARIA CHRISTINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CHRISTINA
Last Name:COYLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:CHRISTINA
Other - Last Name:PRUCHNICKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:500 W 12TH AVE
Mailing Address - Street 2:RM 455
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1214
Mailing Address - Country:US
Mailing Address - Phone:614-292-1363
Mailing Address - Fax:614-292-1335
Practice Address - Street 1:456 W 10TH AVE
Practice Address - Street 2:# 1970A
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-5075
Practice Address - Fax:614-293-3171
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-191241835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy