Provider Demographics
NPI:1578741880
Name:SLAGLE, CONNI (PHARM D)
Entity Type:Individual
Prefix:
First Name:CONNI
Middle Name:
Last Name:SLAGLE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:CONNI
Other - Middle Name:
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:305 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLAYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15323
Mailing Address - Country:US
Mailing Address - Phone:724-663-7707
Mailing Address - Fax:724-663-7707
Practice Address - Street 1:305 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLAYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15323
Practice Address - Country:US
Practice Address - Phone:724-663-7707
Practice Address - Fax:724-663-7707
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist