Provider Demographics
NPI:1912579459
Name:MIHALIC, NATALIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:MIHALIC
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 1:41 W NORTON DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1117
Mailing Address - Country:US
Mailing Address - Phone:126-787-2936
Mailing Address - Fax:
Practice Address - Street 1:13023 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-1672
Practice Address - Country:US
Practice Address - Phone:267-731-6163
Practice Address - Fax:267-731-6164
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044997L1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care