Provider Demographics
NPI:1679882609
Name:LANKEY, CONRAD (BS)
Entity Type:Individual
Prefix:
First Name:CONRAD
Middle Name:
Last Name:LANKEY
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 ACADEMY LANE
Mailing Address - Street 2:PO BOX 205
Mailing Address - City:SOUTHWEST
Mailing Address - State:PA
Mailing Address - Zip Code:15685-0205
Mailing Address - Country:US
Mailing Address - Phone:724-424-1764
Mailing Address - Fax:
Practice Address - Street 1:685 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1600
Practice Address - Country:US
Practice Address - Phone:724-837-4164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042570L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist