Provider Demographics
NPI:1639636046
Name:BILLEY, ANDREA JO (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JO
Last Name:BILLEY
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 1:2281 RIDGEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-2279
Mailing Address - Country:US
Mailing Address - Phone:724-309-3093
Mailing Address - Fax:
Practice Address - Street 1:1901 DAILEY AVE
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-3087
Practice Address - Country:US
Practice Address - Phone:888-432-5936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039811L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP039811LOtherPA STATE BOARD OF PHARMACY