Provider Demographics
NPI:1609259241
Name:RIVERS, SAMANTHA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:RIVERS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 LANCELOT AVE
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5740
Mailing Address - Country:US
Mailing Address - Phone:717-385-7481
Mailing Address - Fax:
Practice Address - Street 1:219 N BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:17065-1204
Practice Address - Country:US
Practice Address - Phone:717-486-8606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARPI009676183500000X
PARP449555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist