Provider Demographics
NPI:1740296896
Name:GOLDMAN, CRAIG ANDREW (RPH)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:ANDREW
Last Name:GOLDMAN
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 1:25 PURDUE DR
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1245
Mailing Address - Country:US
Mailing Address - Phone:215-396-8090
Mailing Address - Fax:215-752-0232
Practice Address - Street 1:970 TOWN CENTER DR
Practice Address - Street 2:SUITE C-15
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1829
Practice Address - Country:US
Practice Address - Phone:215-752-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415544L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0965430001Medicare ID - Type UnspecifiedPHARMACY