Provider Demographics
NPI:1336568526
Name:JANOWSKI, LINDA EILEEN (RPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:EILEEN
Last Name:JANOWSKI
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 1:105 WATERFORD PL SW
Mailing Address - Street 2:
Mailing Address - City:OCEAN ISLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28469-6127
Mailing Address - Country:US
Mailing Address - Phone:910-579-4610
Mailing Address - Fax:
Practice Address - Street 1:105 WATERFORD PL SW
Practice Address - Street 2:
Practice Address - City:OCEAN ISLE BEACH
Practice Address - State:NC
Practice Address - Zip Code:28469-6127
Practice Address - Country:US
Practice Address - Phone:910-579-4610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037404183500000X
NC14116183500000X
SC9507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist