MEDICARE: KAITLYN FAIOLA PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP459956	PA

General Provider Information

NPI Number	:	1649128000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN FAIOLA PHARMD

Provider Business Mailing Address
First Line	:	391 KENNETH DR
Second Line	:
City	:	ROSTRAVER TOWNSHIP
State	:	PA
Zip	:	15012-3881
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 INDEPENDENCE ST
Second Line	:
City	:	PERRYOPOLIS
State	:	PA
Zip	:	15473-5326
Country	:	US
Telephone Number	:	724-736-4422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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