Healthcare Provider Details

I. General information

NPI: 1720377666
Provider Name (Legal Business Name): DEBORAH M. DUNBAR RPH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2011
Last Update Date: 03/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401-403 SOUTH MAIN ST.
OLD FORGE PA
18518
US

IV. Provider business mailing address

401-403 SOUTH MAIN ST.
OLD FORGE PA
18518
US

V. Phone/Fax

Practice location:
  • Phone: 570-457-0844
  • Fax: 570-457-0383
Mailing address:
  • Phone: 570-457-0844
  • Fax: 570-457-0383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP034776L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: