Provider Demographics
NPI:1225485444
Name:KARPOVICH, MARIA THERESA (RPH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:THERESA
Last Name:KARPOVICH
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 1:1026 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:PA
Mailing Address - Zip Code:18644-1331
Mailing Address - Country:US
Mailing Address - Phone:570-693-4572
Mailing Address - Fax:570-693-4578
Practice Address - Street 1:1026 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:PA
Practice Address - Zip Code:18644-1331
Practice Address - Country:US
Practice Address - Phone:570-693-4572
Practice Address - Fax:570-693-4578
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039040L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP039040LOtherPENNSYLVANIA REGISTERED PHARMACIST ID