Provider Demographics
NPI:1467785964
Name:WEIR, COLEEN ANN (RPH)
Entity Type:Individual
Prefix:
First Name:COLEEN
Middle Name:ANN
Last Name:WEIR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 FRIENDSHIP RD
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-5011
Mailing Address - Country:US
Mailing Address - Phone:610-853-3157
Mailing Address - Fax:
Practice Address - Street 1:4000 MONUMENT RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-1600
Practice Address - Country:US
Practice Address - Phone:267-233-5021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038942L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist