Healthcare Provider Details

I. General information

NPI: 1437397882
Provider Name (Legal Business Name): COLE R DYSINGER PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 04/08/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 GATEWAY DRIVE
REEDSVILLE PA
17084
US

IV. Provider business mailing address

10 GATEWAY DRIVE
REEDSVILLE PA
17084
US

V. Phone/Fax

Practice location:
  • Phone: 717-363-9310
  • Fax: 717-363-9313
Mailing address:
  • Phone: 717-363-9310
  • Fax: 717-363-9313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP442946
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRP442946
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: