Provider Demographics
NPI:1356669055
Name:MADAR, DEAN S (RPH)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:S
Last Name:MADAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 STATE ROUTE 981
Mailing Address - Street 2:PO BOX 678
Mailing Address - City:SMITHTON
Mailing Address - State:PA
Mailing Address - Zip Code:15479-0678
Mailing Address - Country:US
Mailing Address - Phone:724-872-4522
Mailing Address - Fax:724-872-4522
Practice Address - Street 1:113 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST NEWTON
Practice Address - State:PA
Practice Address - Zip Code:15089-1141
Practice Address - Country:US
Practice Address - Phone:724-872-6401
Practice Address - Fax:724-872-9743
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035395L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist