Provider Demographics
NPI:1831482173
Name:IMPAGLIA, ERICKA MARIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:MARIE
Last Name:IMPAGLIA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 OLD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-1621
Mailing Address - Country:US
Mailing Address - Phone:570-822-5794
Mailing Address - Fax:570-824-8730
Practice Address - Street 1:250 OLD RIVER RD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-1621
Practice Address - Country:US
Practice Address - Phone:570-822-5794
Practice Address - Fax:570-824-8730
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442976183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist