Provider Demographics
NPI:1245571728
Name:MIRARCHI, THERESE (RPH)
Entity type:Individual
Prefix:MRS
First Name:THERESE
Middle Name:
Last Name:MIRARCHI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PARK DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-3002
Mailing Address - Country:US
Mailing Address - Phone:856-795-4615
Mailing Address - Fax:
Practice Address - Street 1:17 PARK DR
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3002
Practice Address - Country:US
Practice Address - Phone:856-795-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02944800183500000X
PARP044957L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist