Provider Demographics
NPI:1760845358
Name:KHALIFE, NABIL
Entity Type:Individual
Prefix:
First Name:NABIL
Middle Name:
Last Name:KHALIFE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 OAKFORD CIR
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-7836
Mailing Address - Country:US
Mailing Address - Phone:570-237-0617
Mailing Address - Fax:
Practice Address - Street 1:77 OAKFORD CIR
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-7836
Practice Address - Country:US
Practice Address - Phone:570-237-0617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034545R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist