Provider Demographics
NPI:1104922616
Name:SCHRECENGOST KIBBEY, MICHELE A (RPH)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:A
Last Name:SCHRECENGOST KIBBEY
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 1:3215 GREENWALD RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1236
Mailing Address - Country:US
Mailing Address - Phone:412-833-8454
Mailing Address - Fax:
Practice Address - Street 1:120 5TH AVE
Practice Address - Street 2:STE 1812
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3000
Practice Address - Country:US
Practice Address - Phone:412-544-5000
Practice Address - Fax:412-544-4527
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039419L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP0394419LOtherPA STATE LICENSE