Provider Demographics
NPI:1831600147
Name:BAN, MIA ANGELA (RPH)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:ANGELA
Last Name:BAN
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 1:24 SUMMIT PARK DR
Mailing Address - Street 2:ATTN MIA BAN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15275-1104
Mailing Address - Country:US
Mailing Address - Phone:412-680-6970
Mailing Address - Fax:
Practice Address - Street 1:24 SUMMIT PARK DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1104
Practice Address - Country:US
Practice Address - Phone:855-726-8479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451896183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist