Provider Demographics
NPI:1831341676
Name:PICKUP, THERESA (RPH)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:PICKUP
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 1:506 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2733
Mailing Address - Country:US
Mailing Address - Phone:302-762-3847
Mailing Address - Fax:
Practice Address - Street 1:2713 PHILADELPHIA PIKE
Practice Address - Street 2:RITE AID PHARMACY 11177
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2523
Practice Address - Country:US
Practice Address - Phone:302-798-9520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA10002511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist