Provider Demographics
NPI:1639446958
Name:HART, IRVING LON (RPH)
Entity Type:Individual
Prefix:
First Name:IRVING
Middle Name:LON
Last Name:HART
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 WINDING STREAM RD
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:PA
Mailing Address - Zip Code:19475-1681
Mailing Address - Country:US
Mailing Address - Phone:484-938-7018
Mailing Address - Fax:
Practice Address - Street 1:415 WINDING STREAM RD
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:PA
Practice Address - Zip Code:19475-1681
Practice Address - Country:US
Practice Address - Phone:484-938-7018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist