Provider Demographics
NPI:1699259358
Name:BOLANDER, KAREN L (RPH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:BOLANDER
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 1:4800 COUNTY ROAD K
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:OH
Mailing Address - Zip Code:43515-9768
Mailing Address - Country:US
Mailing Address - Phone:419-215-5485
Mailing Address - Fax:
Practice Address - Street 1:4800 COUNTY ROAD K
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:OH
Practice Address - Zip Code:43515-9768
Practice Address - Country:US
Practice Address - Phone:419-215-5485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-22446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist