Provider Demographics
NPI:1225179997
Name:HILDEBRAND, LORI ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANNE
Last Name:HILDEBRAND
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 1:4576 PENNS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SPRING MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:16875-8500
Mailing Address - Country:US
Mailing Address - Phone:814-422-8911
Mailing Address - Fax:
Practice Address - Street 1:4752 STATE ROUTE 655 STE A
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17004-9272
Practice Address - Country:US
Practice Address - Phone:814-422-8911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043396L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist