Healthcare Provider Details

I. General information

NPI: 1326031378
Provider Name (Legal Business Name): ROBERT JOSEPH INGOLDSBY B.S. PHARMACY
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2612 FREEPORT RD
NATRONA HEIGHTS PA
15065-2513
US

IV. Provider business mailing address

218 ALTERMOOR DR
NATRONA HEIGHTS PA
15065-9723
US

V. Phone/Fax

Practice location:
  • Phone: 724-224-7111
  • Fax: 724-224-0443
Mailing address:
  • Phone: 724-295-0478
  • Fax: 724-224-0443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP027806L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: