Provider Demographics
NPI:1073954079
Name:VARGO, KATELYN SCHULTZ (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:SCHULTZ
Last Name:VARGO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:ANN
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:10 CLAY PIKE
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-2039
Mailing Address - Country:US
Mailing Address - Phone:724-863-2350
Mailing Address - Fax:
Practice Address - Street 1:621 CLAY AVE
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3409
Practice Address - Country:US
Practice Address - Phone:724-527-3888
Practice Address - Fax:724-523-8247
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP446665183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist