Provider Demographics
NPI:1205025558
Name:CALLAHAN, MARIE A (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:A
Last Name:CALLAHAN
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 1:869 DERBY DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-3988
Mailing Address - Country:US
Mailing Address - Phone:610-696-7941
Mailing Address - Fax:
Practice Address - Street 1:869 DERBY DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-3988
Practice Address - Country:US
Practice Address - Phone:610-696-7941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038227L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist