Provider Demographics
NPI:1619698081
Name:FRITSCH, ABIGALE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ABIGALE
Middle Name:
Last Name:FRITSCH
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 1:2430 KESTRAL BLVD APT C
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-6534
Mailing Address - Country:US
Mailing Address - Phone:224-321-0332
Mailing Address - Fax:
Practice Address - Street 1:575 STADIUM MALL DR
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47907-2091
Practice Address - Country:US
Practice Address - Phone:765-494-1374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029846A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist