Provider Demographics
NPI:1841820594
Name:LEWANDOWSKI, KATHRYN
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:LEWANDOWSKI
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 1:1670 HIGHWAY 124 N STE F
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5646
Mailing Address - Country:US
Mailing Address - Phone:770-985-3792
Mailing Address - Fax:770-985-5285
Practice Address - Street 1:1670 HIGHWAY 124 N STE F
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-5646
Practice Address - Country:US
Practice Address - Phone:770-985-3792
Practice Address - Fax:770-985-5285
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0242451835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist