Provider Demographics
NPI:1619578424
Name:FISHER, LAURIE A (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:A
Last Name:FISHER
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 1:325 W FREEDOM AVE
Mailing Address - Street 2:
Mailing Address - City:BURNHAM
Mailing Address - State:PA
Mailing Address - Zip Code:17009-1846
Mailing Address - Country:US
Mailing Address - Phone:717-242-3141
Mailing Address - Fax:717-242-3143
Practice Address - Street 1:325 W FREEDOM AVE
Practice Address - Street 2:
Practice Address - City:BURNHAM
Practice Address - State:PA
Practice Address - Zip Code:17009-1846
Practice Address - Country:US
Practice Address - Phone:717-242-3141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039332L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist