Provider Demographics
NPI:1366612517
Name:BANKOVIC, HEATHER (RPH)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:BANKOVIC
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 1:1102 MILLION DOLLAR HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-2728
Mailing Address - Country:US
Mailing Address - Phone:814-781-1389
Mailing Address - Fax:814-781-1414
Practice Address - Street 1:1102 MILLION DOLLAR HWY
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-2728
Practice Address - Country:US
Practice Address - Phone:814-781-1389
Practice Address - Fax:814-781-1414
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041854L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist