Provider Demographics
NPI:1891043980
Name:BALZARINI, PATRICIA JOANNE (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JOANNE
Last Name:BALZARINI
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 1:30840 PRUDHOE BAY AVE
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-9737
Mailing Address - Country:US
Mailing Address - Phone:907-696-7534
Mailing Address - Fax:
Practice Address - Street 1:30840 PRUDHOE BAY AVE
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-9737
Practice Address - Country:US
Practice Address - Phone:907-696-7534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK9881835G0303X
HI31511835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric