Provider Demographics
NPI:1720681646
Name:DOUAIHY, VINCENT A (RPH)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:A
Last Name:DOUAIHY
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 1:8 E HEMLOCK ST
Mailing Address - Street 2:
Mailing Address - City:HARVEYS LAKE
Mailing Address - State:PA
Mailing Address - Zip Code:18618-3159
Mailing Address - Country:US
Mailing Address - Phone:570-430-5502
Mailing Address - Fax:
Practice Address - Street 1:110 GREEN RIDGE ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-1810
Practice Address - Country:US
Practice Address - Phone:570-344-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035289L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist