Provider Demographics
NPI:1205118262
Name:SCHILDKAMP, ANGELA RENEE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:RENEE
Last Name:SCHILDKAMP
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 1:4037 GREAT STAR CT
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-4768
Mailing Address - Country:US
Mailing Address - Phone:724-205-1921
Mailing Address - Fax:
Practice Address - Street 1:2801 SHARKYS DR
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-4231
Practice Address - Country:US
Practice Address - Phone:724-539-8467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3992410OtherNABP