Provider Demographics
NPI:1518022003
Name:CUNNINGHAM, COURTNEY ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ANN
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WASHINGTON PARK RD
Mailing Address - Street 2:APT 4
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-6713
Mailing Address - Country:US
Mailing Address - Phone:570-498-1276
Mailing Address - Fax:
Practice Address - Street 1:104 MAIN ST
Practice Address - Street 2:
Practice Address - City:LACEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18623
Practice Address - Country:US
Practice Address - Phone:570-869-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440409183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist