Provider Demographics
NPI:1821219437
Name:ANGELINI, DAVID R (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:ANGELINI
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 1:224 PUMPKIN RUN ROAD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:PA
Mailing Address - Zip Code:15344
Mailing Address - Country:US
Mailing Address - Phone:724-592-6209
Mailing Address - Fax:724-966-9330
Practice Address - Street 1:555 ROUTE 88
Practice Address - Street 2:
Practice Address - City:CARMICHAELS
Practice Address - State:PA
Practice Address - Zip Code:15320
Practice Address - Country:US
Practice Address - Phone:724-966-5237
Practice Address - Fax:724-966-9330
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP029384L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist