Healthcare Provider Details

I. General information

NPI: 1265342422
Provider Name (Legal Business Name): KELLY JO BOBBS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WATERDAM PLAZA DR STE 240
MC MURRAY PA
15317-5427
US

IV. Provider business mailing address

959 LINDEN RD
EIGHTY FOUR PA
15330-2525
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-2018
  • Fax:
Mailing address:
  • Phone: 412-439-9032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP046380
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: