Healthcare Provider Details

I. General information

NPI: 1013562859
Provider Name (Legal Business Name): WILLIAM DONALD POPP RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 MAIN ST
HELLERTOWN PA
18055-1716
US

IV. Provider business mailing address

168 KINGSBURY CT
NAZARETH PA
18064-1121
US

V. Phone/Fax

Practice location:
  • Phone: 610-838-7371
  • Fax: 610-838-0141
Mailing address:
  • Phone: 610-417-4473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP038676R
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: