Provider Demographics
NPI:1851402408
Name:JOSEPHIC, KENDRA L (RPH)
Entity Type:Individual
Prefix:DR
First Name:KENDRA
Middle Name:L
Last Name:JOSEPHIC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 SHUMAKER DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1081
Mailing Address - Country:US
Mailing Address - Phone:412-372-5051
Mailing Address - Fax:
Practice Address - Street 1:12238 FRANKSTOWN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-3404
Practice Address - Country:US
Practice Address - Phone:412-798-9800
Practice Address - Fax:412-798-4572
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP438454OtherSTATE PHARMACY LICENSE