Provider Demographics
NPI:1114522067
Name:KALIE, JOANNE R (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:R
Last Name:KALIE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-4606
Mailing Address - Country:US
Mailing Address - Phone:570-752-7462
Mailing Address - Fax:570-759-3518
Practice Address - Street 1:700 W FRONT ST
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-4606
Practice Address - Country:US
Practice Address - Phone:570-752-7462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist