Provider Demographics
NPI:1205235413
Name:BICKHART, GENA RAE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GENA
Middle Name:RAE
Last Name:BICKHART
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 1:348 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-1436
Mailing Address - Country:US
Mailing Address - Phone:412-216-1428
Mailing Address - Fax:
Practice Address - Street 1:348 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-1436
Practice Address - Country:US
Practice Address - Phone:412-216-1428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447507183500000X
PARPI007222183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist