Provider Demographics
NPI:1962006122
Name:SOBOLESKI, AMY (RPH)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SOBOLESKI
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 1:630 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-1308
Mailing Address - Country:US
Mailing Address - Phone:717-898-8589
Mailing Address - Fax:717-898-8589
Practice Address - Street 1:630 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1308
Practice Address - Country:US
Practice Address - Phone:717-898-8589
Practice Address - Fax:717-898-1637
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-044892-L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist