Provider Demographics
NPI:1053644740
Name:WALCZYK, TAMARA L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:L
Last Name:WALCZYK
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 1:900 COMMONWEALTH DR
Mailing Address - Street 2:SUITE 900
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066
Mailing Address - Country:US
Mailing Address - Phone:724-742-3528
Mailing Address - Fax:724-741-3122
Practice Address - Street 1:900 COMMONWEALTH DR
Practice Address - Street 2:SUITE 900
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066
Practice Address - Country:US
Practice Address - Phone:724-742-3528
Practice Address - Fax:724-741-3122
Is Sole Proprietor?:No
Enumeration Date:2009-09-12
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043292L183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist