Healthcare Provider Details

I. General information

NPI: 1407909625
Provider Name (Legal Business Name): PAUL M SAXON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 PIERCE ST
KINGSTON PA
18704-5568
US

IV. Provider business mailing address

327 CRANES RD
SHAVERTON PA
18708-9666
US

V. Phone/Fax

Practice location:
  • Phone: 570-288-4519
  • Fax: 570-283-2089
Mailing address:
  • Phone: 570-696-1745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP029158L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: