Provider Demographics
NPI:1669789756
Name:MUJKOVIC, ALEMINA
Entity type:Individual
Prefix:
First Name:ALEMINA
Middle Name:
Last Name:MUJKOVIC
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 1:6542 LOGAN SQUARE
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-3455
Mailing Address - Country:US
Mailing Address - Phone:215-862-9228
Mailing Address - Fax:215-862-9268
Practice Address - Street 1:6542 LOGAN SQ
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:PA
Practice Address - Zip Code:18938-3455
Practice Address - Country:US
Practice Address - Phone:267-799-4215
Practice Address - Fax:215-862-9268
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist