Provider Demographics
NPI:1154911972
Name:EL KHOURY ISSA, ROSALINE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ROSALINE
Middle Name:
Last Name:EL KHOURY ISSA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ROSALINE
Other - Middle Name:
Other - Last Name:EL-KHOURY ISSA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:351 W SCHUYLKILL RD
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-7438
Mailing Address - Country:US
Mailing Address - Phone:610-970-7388
Mailing Address - Fax:
Practice Address - Street 1:351 W SCHUYLKILL RD
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465-7438
Practice Address - Country:US
Practice Address - Phone:610-970-7388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist