Provider Demographics
NPI:1215663356
Name:PIETRANEK, SOPHIE E (RPH)
Entity type:Individual
Prefix:DR
First Name:SOPHIE
Middle Name:E
Last Name:PIETRANEK
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 1:56 BALMORAL WAY APT 2E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-6421
Mailing Address - Country:US
Mailing Address - Phone:224-548-4441
Mailing Address - Fax:
Practice Address - Street 1:4650 S EMERSON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-5932
Practice Address - Country:US
Practice Address - Phone:317-783-1484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029823A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist