Provider Demographics
NPI:1205950128
Name:PIHA, DON JR (RPH)
Entity type:Individual
Prefix:MR
First Name:DON
Middle Name:
Last Name:PIHA
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-3645
Mailing Address - Country:US
Mailing Address - Phone:708-371-0343
Mailing Address - Fax:708-371-5931
Practice Address - Street 1:6401 W 127TH ST
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-2247
Practice Address - Country:US
Practice Address - Phone:708-371-0343
Practice Address - Fax:708-371-5931
Is Sole Proprietor?:No
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051033768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist