Provider Demographics
NPI:1700906534
Name:BALON, JANIE COBUN (RPH)
Entity type:Individual
Prefix:MRS
First Name:JANIE
Middle Name:COBUN
Last Name:BALON
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 1:311 EMERALD DR
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-5730
Mailing Address - Country:US
Mailing Address - Phone:814-419-8183
Mailing Address - Fax:
Practice Address - Street 1:311 EMERALD DR
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-5730
Practice Address - Country:US
Practice Address - Phone:814-419-8183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031397L183500000X
VA0202006482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist