Healthcare Provider Details

I. General information

NPI: 1003330804
Provider Name (Legal Business Name): ALISON BURKHOLDER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2936 W 17TH ST
ERIE PA
16505-3929
US

IV. Provider business mailing address

8841 HAMOT RD
WATERFORD PA
16441-4043
US

V. Phone/Fax

Practice location:
  • Phone: 814-838-2102
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP451592
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: