Provider Demographics
NPI:1851782874
Name:NAKHLA, MINA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MINA
Middle Name:
Last Name:NAKHLA
Suffix:
Gender:M
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 1:700 E TOWNSHIP LINE RD
Mailing Address - Street 2:205
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-5733
Mailing Address - Country:US
Mailing Address - Phone:484-441-1000
Mailing Address - Fax:484-441-1003
Practice Address - Street 1:700 E TOWNSHIP LINE RD
Practice Address - Street 2:205
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-5733
Practice Address - Country:US
Practice Address - Phone:484-441-1000
Practice Address - Fax:484-441-1003
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist