Provider Demographics
NPI:1366543548
Name:BANDFIELD, PAUL R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:R
Last Name:BANDFIELD
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 1:6320 GREENWOOD PKWY APT 405
Mailing Address - Street 2:
Mailing Address - City:SAGAMORE HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2352
Mailing Address - Country:US
Mailing Address - Phone:330-908-2922
Mailing Address - Fax:216-265-4483
Practice Address - Street 1:12301 SNOW RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44130-1002
Practice Address - Country:US
Practice Address - Phone:216-265-4406
Practice Address - Fax:216-265-4483
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-26780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist