Provider Demographics
NPI:1336695840
Name:IOANNIDIS, VASILIOS (PHARMD)
Entity Type:Individual
Prefix:
First Name:VASILIOS
Middle Name:
Last Name:IOANNIDIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 N READING RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1647
Mailing Address - Country:US
Mailing Address - Phone:717-721-5784
Mailing Address - Fax:
Practice Address - Street 1:183 N READING RD
Practice Address - Street 2:SUITE 9
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1647
Practice Address - Country:US
Practice Address - Phone:717-721-5784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP450843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist