Provider Demographics
NPI:1245085976
Name:RANCK, ABAGAIL ELIZABETH
Entity type:Individual
Prefix:
First Name:ABAGAIL
Middle Name:ELIZABETH
Last Name:RANCK
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 1:456 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-2044
Mailing Address - Country:US
Mailing Address - Phone:570-847-4258
Mailing Address - Fax:
Practice Address - Street 1:16 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:PA
Practice Address - Zip Code:17847-9237
Practice Address - Country:US
Practice Address - Phone:833-742-6500
Practice Address - Fax:570-989-9233
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30257806183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician