Provider Demographics
NPI:1306006911
Name:ATHANAS, CAROLINE (RPH)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:ATHANAS
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 1:113 E BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:19018-1603
Mailing Address - Country:US
Mailing Address - Phone:610-622-3225
Mailing Address - Fax:
Practice Address - Street 1:113 E BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:19018-1603
Practice Address - Country:US
Practice Address - Phone:610-622-3225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP037383L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist