Provider Demographics
NPI:1346519535
Name:KREBS, CORY J
Entity Type:Individual
Prefix:MR
First Name:CORY
Middle Name:J
Last Name:KREBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 STEEPLECHASE DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-2244
Mailing Address - Country:US
Mailing Address - Phone:724-432-3199
Mailing Address - Fax:
Practice Address - Street 1:100 HIGHTOWER BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-1134
Practice Address - Country:US
Practice Address - Phone:412-788-0438
Practice Address - Fax:412-787-5089
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS12221183500000X
PARP441196183500000X
WV7435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist