Provider Demographics
NPI:1487088456
Name:KOWALSKI, MATTHEW ALEXANDER (PHARMD)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:ALEXANDER
Last Name:KOWALSKI
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 1:25524 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-4048
Mailing Address - Country:US
Mailing Address - Phone:440-892-0525
Mailing Address - Fax:
Practice Address - Street 1:25524 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4048
Practice Address - Country:US
Practice Address - Phone:440-892-0525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist