Provider Demographics
NPI:1518394758
Name:WAGONER, BARBARA L (RPH)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:L
Last Name:WAGONER
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 1:500 NOBLESTOWN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-1230
Mailing Address - Country:US
Mailing Address - Phone:412-353-4244
Mailing Address - Fax:412-325-6505
Practice Address - Street 1:500 NOBLESTOWN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-1230
Practice Address - Country:US
Practice Address - Phone:412-353-4244
Practice Address - Fax:412-325-6505
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039943L1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist