Provider Demographics
NPI:1932986759
Name:PAWLAK, MADISON GRACE (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:GRACE
Last Name:PAWLAK
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 GOLD DR
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-7741
Mailing Address - Country:US
Mailing Address - Phone:724-856-9985
Mailing Address - Fax:
Practice Address - Street 1:1900 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1216
Practice Address - Country:US
Practice Address - Phone:419-423-5456
Practice Address - Fax:419-423-5457
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03443637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist