Provider Demographics
NPI:1154971737
Name:FRASCH, MAURA KATHLEEN
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:KATHLEEN
Last Name:FRASCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9333 STATE ROUTE 61 STE 2
Mailing Address - Street 2:
Mailing Address - City:COAL TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:17866-4170
Mailing Address - Country:US
Mailing Address - Phone:570-205-1540
Mailing Address - Fax:
Practice Address - Street 1:9333 STATE ROUTE 61 STE 2
Practice Address - Street 2:
Practice Address - City:COAL TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:17866-4170
Practice Address - Country:US
Practice Address - Phone:570-644-6198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453987183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist