Provider Demographics
NPI:1215551072
Name:CHRISTINE, MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:CHRISTINE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-9267
Mailing Address - Country:US
Mailing Address - Phone:610-703-7455
Mailing Address - Fax:
Practice Address - Street 1:7505 CEDAR RD
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-9267
Practice Address - Country:US
Practice Address - Phone:610-703-7455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-07
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044729L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist