Provider Demographics
NPI:1619295722
Name:MARKANTONE, MADELEINE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MADELEINE
Middle Name:
Last Name:MARKANTONE
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 1:3642 FORBES TRAIL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668
Mailing Address - Country:US
Mailing Address - Phone:412-782-2277
Mailing Address - Fax:412-782-5601
Practice Address - Street 1:1125 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3103
Practice Address - Country:US
Practice Address - Phone:412-782-2277
Practice Address - Fax:412-782-5601
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP003965L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist