Provider Demographics
NPI:1407324262
Name:WOLFE, DOMINIKA (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:DOMINIKA
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15260-2 KUTZTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530
Mailing Address - Country:US
Mailing Address - Phone:610-683-5827
Mailing Address - Fax:
Practice Address - Street 1:15260-2 KUTZTOWN ROAD
Practice Address - Street 2:
Practice Address - City:KUTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19530
Practice Address - Country:US
Practice Address - Phone:610-683-5827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP452333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist