Healthcare Provider Details

I. General information

NPI: 1831225440
Provider Name (Legal Business Name): DIANE HRISHENKO BS PHARMACY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 E STATE STREET PHARMACY
SHARON PA
16146
US

IV. Provider business mailing address

699 E STATE ST
SHARON PA
16146
US

V. Phone/Fax

Practice location:
  • Phone: 724-983-5640
  • Fax: 724-983-3979
Mailing address:
  • Phone: 724-983-3817
  • Fax: 724-983-3941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP033008L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: