1649360181 NPI number — PAULA K OLDHAM RPH

Table of content: PAULA K OLDHAM RPH (NPI 1649360181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649360181 NPI number — PAULA K OLDHAM RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLDHAM
Provider First Name:
PAULA
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649360181
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 321
Provider Second Line Business Mailing Address:
6 SUMMIT ST
Provider Business Mailing Address City Name:
BROOKVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15825-0321
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-849-3193
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
240 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15825-2514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-849-5217
Provider Business Practice Location Address Fax Number:
814-849-4373
Provider Enumeration Date:
10/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RP032146L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RP032146L . This is a "PHARMACIST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com