Provider Demographics
NPI:1558653295
Name:KOCIS, KAREN A (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:KOCIS
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 RESORT PLAZA DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15717-7964
Mailing Address - Country:US
Mailing Address - Phone:724-459-5938
Mailing Address - Fax:724-459-5034
Practice Address - Street 1:200 RESORT PLAZA DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BLAIRSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15717-7964
Practice Address - Country:US
Practice Address - Phone:724-459-5938
Practice Address - Fax:724-459-5034
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP028080L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist