Provider Demographics
NPI:1962097279
Name:MAIOLINI, MORGAN TATE (PHARMD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:TATE
Last Name:MAIOLINI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1362 LITITZ PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-290-2012
Mailing Address - Fax:
Practice Address - Street 1:1262 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4340
Practice Address - Country:US
Practice Address - Phone:717-290-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP455308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist