Healthcare Provider Details

I. General information

NPI: 1437162468
Provider Name (Legal Business Name): GERARD EDWARD OHARE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 W PIKE ST
CANONSBURG PA
15317-1314
US

IV. Provider business mailing address

320 SUGAR CAMP RD
VENETIA PA
15367-1149
US

V. Phone/Fax

Practice location:
  • Phone: 724-745-6480
  • Fax: 724-745-8818
Mailing address:
  • Phone: 724-413-8492
  • Fax: 724-745-8818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP031890L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: