Provider Demographics
NPI:1629119904
Name:GROVES, CHRISTINE LEA (RPH)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:LEA
Last Name:GROVES
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 1:4013 STATE ROUTE 18
Mailing Address - Street 2:
Mailing Address - City:WAMPUM
Mailing Address - State:PA
Mailing Address - Zip Code:16157-2137
Mailing Address - Country:US
Mailing Address - Phone:724-535-4756
Mailing Address - Fax:
Practice Address - Street 1:1275 N HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3110
Practice Address - Country:US
Practice Address - Phone:724-346-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032542L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist