Provider Demographics
NPI:1750984001
Name:PRICE, VICKI JEAN (RPH)
Entity type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:JEAN
Last Name:PRICE
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 1:131 SCHOOLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:JENNERSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15547-9155
Mailing Address - Country:US
Mailing Address - Phone:814-629-1397
Mailing Address - Fax:
Practice Address - Street 1:131 SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:JENNERSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15547-9155
Practice Address - Country:US
Practice Address - Phone:814-629-1397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03212573183500000X
PARP031573L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist