Provider Demographics
NPI:1194959437
Name:JOHNSON, SONYA C (RPH)
Entity type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:C
Last Name:JOHNSON
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 1:1137 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1416
Mailing Address - Country:US
Mailing Address - Phone:717-737-3359
Mailing Address - Fax:717-737-9665
Practice Address - Street 1:1137 MARKET ST
Practice Address - Street 2:
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1416
Practice Address - Country:US
Practice Address - Phone:717-737-3359
Practice Address - Fax:717-737-9665
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042486L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist