Provider Demographics
NPI:1154934917
Name:PARDO, CONOR MICHAEL (PHARMD)
Entity type:Individual
Prefix:
First Name:CONOR
Middle Name:MICHAEL
Last Name:PARDO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 N HIGH ST UNIT 410
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-6442
Mailing Address - Country:US
Mailing Address - Phone:708-205-8009
Mailing Address - Fax:
Practice Address - Street 1:2770 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-2641
Practice Address - Country:US
Practice Address - Phone:708-205-8009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26027566A183500000X
OH03439862183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist