Provider Demographics
NPI:1659670420
Name:KNEPPER, KIRBY SCOTT (RPH)
Entity Type:Individual
Prefix:
First Name:KIRBY
Middle Name:SCOTT
Last Name:KNEPPER
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 1:131 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MC CONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233-1007
Mailing Address - Country:US
Mailing Address - Phone:202-905-7957
Mailing Address - Fax:814-542-4229
Practice Address - Street 1:101 E SHIRLEY ST
Practice Address - Street 2:
Practice Address - City:MOUNT UNION
Practice Address - State:PA
Practice Address - Zip Code:17066-1600
Practice Address - Country:US
Practice Address - Phone:814-542-8003
Practice Address - Fax:814-542-4229
Is Sole Proprietor?:No
Enumeration Date:2011-03-20
Last Update Date:2011-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443877183500000X
VA0202011771183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist