Provider Demographics
NPI:1700246436
Name:FITZPATRICK, MICHAEL (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:FITZPATRICK
Suffix:
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 1:220 EXECUTIVE DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6413
Mailing Address - Country:US
Mailing Address - Phone:724-772-3705
Mailing Address - Fax:724-772-0696
Practice Address - Street 1:220 EXECUTIVE DR
Practice Address - Street 2:SUITE 500
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6413
Practice Address - Country:US
Practice Address - Phone:724-772-3705
Practice Address - Fax:724-772-0696
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034687L1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist