Provider Demographics
NPI:1710583745
Name:PAINVIN, AMY FOWLER
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:FOWLER
Last Name:PAINVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9608 RIVERWAY RUN
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8374
Mailing Address - Country:US
Mailing Address - Phone:415-577-0149
Mailing Address - Fax:
Practice Address - Street 1:1211 MORSE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-6320
Practice Address - Country:US
Practice Address - Phone:614-268-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13564541835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care