Provider Demographics
NPI:1386950822
Name:PHILLIPS, ANITA M (RPH)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:PHILLIPS
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 1:117 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3541
Mailing Address - Country:US
Mailing Address - Phone:724-942-5610
Mailing Address - Fax:
Practice Address - Street 1:2279 MAIN ST
Practice Address - Street 2:
Practice Address - City:MUNHALL
Practice Address - State:PA
Practice Address - Zip Code:15120-2652
Practice Address - Country:US
Practice Address - Phone:412-461-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-22
Last Update Date:2010-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038128L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist