Healthcare Provider Details

I. General information

NPI: 1073954079
Provider Name (Legal Business Name): KATELYN SCHULTZ VARGO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATELYN ANN SCHULTZ PHARMD

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 CLAY AVE
JEANNETTE PA
15644-3409
US

IV. Provider business mailing address

10 CLAY PIKE
IRWIN PA
15642-2039
US

V. Phone/Fax

Practice location:
  • Phone: 724-527-3888
  • Fax: 724-523-8247
Mailing address:
  • Phone: 724-863-2350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP446665
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: