Provider Demographics
NPI:1922668219
Name:KOWALSKI, ANDREA (RPH, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 FRANKLIN CT
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3143
Mailing Address - Country:US
Mailing Address - Phone:330-289-8777
Mailing Address - Fax:
Practice Address - Street 1:120 S BUCKEYE ST
Practice Address - Street 2:
Practice Address - City:CROOKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43731-1015
Practice Address - Country:US
Practice Address - Phone:740-982-8158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03234020183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist