Provider Demographics
NPI:1790994903
Name:PIPPIS, CONSTANTINE NICHOLAS (RPH)
Entity Type:Individual
Prefix:
First Name:CONSTANTINE
Middle Name:NICHOLAS
Last Name:PIPPIS
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 1:485 BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1161
Mailing Address - Country:US
Mailing Address - Phone:484-840-2600
Mailing Address - Fax:484-840-2604
Practice Address - Street 1:485 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1161
Practice Address - Country:US
Practice Address - Phone:484-840-2600
Practice Address - Fax:484-840-2604
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036102L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist