Provider Demographics
NPI:1902131139
Name:PAGE, DEBORAH
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:PAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4827 LETTERKENNY RD W
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-8789
Mailing Address - Country:US
Mailing Address - Phone:717-262-5683
Mailing Address - Fax:
Practice Address - Street 1:757 NORLAND AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4230
Practice Address - Country:US
Practice Address - Phone:717-217-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist