Provider Demographics
NPI:1912220260
Name:SACK, HAROLD ANTHONY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:ANTHONY
Last Name:SACK
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 1:6008 PEBBLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-3264
Mailing Address - Country:US
Mailing Address - Phone:814-882-9911
Mailing Address - Fax:
Practice Address - Street 1:1900 KEYSTONE DR
Practice Address - Street 2:SUITE 30
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-7702
Practice Address - Country:US
Practice Address - Phone:814-864-7619
Practice Address - Fax:814-864-8190
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist