Provider Demographics
NPI:1104598853
Name:GEARHART, TAMMY LORRAINE (PHARMD)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LORRAINE
Last Name:GEARHART
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 PHILAPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHERN CAMBRIA
Mailing Address - State:PA
Mailing Address - Zip Code:15714
Mailing Address - Country:US
Mailing Address - Phone:814-948-6102
Mailing Address - Fax:
Practice Address - Street 1:1120 PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:NORTHERN CAMBRIA
Practice Address - State:PA
Practice Address - Zip Code:15714-1359
Practice Address - Country:US
Practice Address - Phone:814-948-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP046308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist