Provider Demographics
NPI:1932483211
Name:BOLDING, DAWN M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:M
Last Name:BOLDING
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 1:1195 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-1207
Mailing Address - Country:US
Mailing Address - Phone:317-462-8923
Mailing Address - Fax:317-462-9028
Practice Address - Street 1:1195 N STATE ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-1207
Practice Address - Country:US
Practice Address - Phone:317-462-8923
Practice Address - Fax:317-462-9028
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018199A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist