Provider Demographics
NPI:1922779180
Name:RIDDELL, DARLA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DARLA
Middle Name:
Last Name:RIDDELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:LIGONIER
Mailing Address - State:PA
Mailing Address - Zip Code:15658-1034
Mailing Address - Country:US
Mailing Address - Phone:724-238-0342
Mailing Address - Fax:724-238-0363
Practice Address - Street 1:117 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:PA
Practice Address - Zip Code:15658-1034
Practice Address - Country:US
Practice Address - Phone:724-238-0342
Practice Address - Fax:724-238-0363
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist