Provider Demographics
NPI:1851304141
Name:THACKER, DIANE MARIA (RPH)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:MARIA
Last Name:THACKER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4818 TOFTREES DR
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2352
Mailing Address - Country:US
Mailing Address - Phone:184-443-5101
Mailing Address - Fax:412-688-6193
Practice Address - Street 1:VA PITTSBURGH HEALTHCARE SYSTEM
Practice Address - Street 2:UNIVERSITY DRIVE C (132M-U)
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-784-3559
Practice Address - Fax:412-688-6193
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031826L1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy