Healthcare Provider Details

I. General information

NPI: 1851314579
Provider Name (Legal Business Name): DEBRA ANN MEKOSH RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 S OAK ST
MOUNT CARMEL PA
17851-2164
US

IV. Provider business mailing address

49 S OAK ST
MOUNT CARMEL PA
17851-2164
US

V. Phone/Fax

Practice location:
  • Phone: 570-339-1460
  • Fax: 570-339-5902
Mailing address:
  • Phone: 570-339-1460
  • Fax: 570-339-5902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP039542L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: