Provider Demographics
NPI:1962979971
Name:PAONE, JAMES ANTHONY
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ANTHONY
Last Name:PAONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 WISHART DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-9526
Mailing Address - Country:US
Mailing Address - Phone:412-417-8744
Mailing Address - Fax:878-313-3123
Practice Address - Street 1:RITE AID PHARMACY DISTRICT OFFICE
Practice Address - Street 2:629 ALPHA DRIVE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238
Practice Address - Country:US
Practice Address - Phone:412-967-8758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03337741183500000X
PARP030195L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist