Provider Demographics
NPI:1164143160
Name:WIEWIORA, CRAIG JOSEPH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:JOSEPH
Last Name:WIEWIORA
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 1:101 PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHERN CAMBRIA
Mailing Address - State:PA
Mailing Address - Zip Code:15714-1607
Mailing Address - Country:US
Mailing Address - Phone:814-691-5517
Mailing Address - Fax:
Practice Address - Street 1:1212 2ND ST
Practice Address - Street 2:
Practice Address - City:CRESSON
Practice Address - State:PA
Practice Address - Zip Code:16630-1148
Practice Address - Country:US
Practice Address - Phone:814-886-2677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist