Provider Demographics
NPI:1033426226
Name:DISCOVICH, MARLA RAE (RPH)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:RAE
Last Name:DISCOVICH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MARLA
Other - Middle Name:RAE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:142 ELMA AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4123
Mailing Address - Country:US
Mailing Address - Phone:724-439-4469
Mailing Address - Fax:724-430-1453
Practice Address - Street 1:262 CONNELLSVILLE ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3814
Practice Address - Country:US
Practice Address - Phone:724-438-9799
Practice Address - Fax:724-430-1453
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035285L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist