Provider Demographics
NPI:1568494912
Name:KOERNER, PAMELA HUCKO (RPH, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:HUCKO
Last Name:KOERNER
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2548 CLUBHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7955
Mailing Address - Country:US
Mailing Address - Phone:724-935-6504
Mailing Address - Fax:412-380-8597
Practice Address - Street 1:4105 MONROEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2607
Practice Address - Country:US
Practice Address - Phone:412-380-7907
Practice Address - Fax:412-380-8597
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043659L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist