Provider Demographics
NPI:1548241748
Name:PANKO, ANDREW T III (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:T
Last Name:PANKO
Suffix:III
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 1:221 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:CATAWISSA
Mailing Address - State:PA
Mailing Address - Zip Code:17820-8754
Mailing Address - Country:US
Mailing Address - Phone:570-799-0424
Mailing Address - Fax:570-799-5574
Practice Address - Street 1:210 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:ELYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17824-9770
Practice Address - Country:US
Practice Address - Phone:844-878-5562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044697L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist