Provider Demographics
NPI:1902390362
Name:POMPEY, ELISSA MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:MARIE
Last Name:POMPEY
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 1:605 GINO MERLI DR
Mailing Address - Street 2:
Mailing Address - City:PECKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18452-1635
Mailing Address - Country:US
Mailing Address - Phone:570-499-4940
Mailing Address - Fax:
Practice Address - Street 1:605 GINO MERLI DR
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452-1635
Practice Address - Country:US
Practice Address - Phone:570-499-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038419L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist