Healthcare Provider Details

I. General information

NPI: 1437508231
Provider Name (Legal Business Name): SUMMER RIFKAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2016
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 JUNE DR
ROARING SPRING PA
16673-2316
US

IV. Provider business mailing address

94 JUNE DR
ROARING SPRING PA
16673-2316
US

V. Phone/Fax

Practice location:
  • Phone: 814-224-5553
  • Fax: 814-224-5827
Mailing address:
  • Phone: 814-224-5553
  • Fax: 814-224-5827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP044689R
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: