Provider Demographics
NPI:1972265650
Name:MOSCALINK, KATIE LYNN
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:LYNN
Last Name:MOSCALINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-5537
Mailing Address - Country:US
Mailing Address - Phone:724-434-2704
Mailing Address - Fax:
Practice Address - Street 1:180 W MAIN ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-5537
Practice Address - Country:US
Practice Address - Phone:724-434-2704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-09
Last Update Date:2023-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28499183500000X
PARP456191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD28499OtherSTATE BOARD OF PHARMACY
PARP456191OtherSTATE BOARD OF PHARMACY