Provider Demographics
NPI:1689348450
Name:BONK, LINDA C (RPH)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:C
Last Name:BONK
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 1:105 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:SHAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18708-1009
Mailing Address - Country:US
Mailing Address - Phone:570-466-2485
Mailing Address - Fax:
Practice Address - Street 1:2460 MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-9248
Practice Address - Country:US
Practice Address - Phone:570-675-4807
Practice Address - Fax:570-675-3741
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-30513L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist