Provider Demographics
NPI:1326649328
Name:MARCOZ, KRISTIN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:MARCOZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:KRISTIN
Other - Middle Name:PETERS
Other - Last Name:MARCOZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2889 KINGSTON CT
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-9629
Mailing Address - Country:US
Mailing Address - Phone:724-861-5343
Mailing Address - Fax:
Practice Address - Street 1:2100 SUMMIT RIDGE PLZ STE 1
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-9199
Practice Address - Country:US
Practice Address - Phone:724-542-0374
Practice Address - Fax:724-542-0376
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist