Provider Demographics
NPI:1588778989
Name:WHIPPLE, LARRY LEROY (RPH)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:LEROY
Last Name:WHIPPLE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7888 CLEMENS RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16438-7608
Mailing Address - Country:US
Mailing Address - Phone:814-438-7454
Mailing Address - Fax:
Practice Address - Street 1:7888 CLEMENS RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:PA
Practice Address - Zip Code:16438-7608
Practice Address - Country:US
Practice Address - Phone:814-438-7454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031383L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA15021699OtherDRIVERS LICENSE
PARP031383LOtherPHARMACIST LICENSE