Healthcare Provider Details

I. General information

NPI: 1780281600
Provider Name (Legal Business Name): BRIANNA MARIE BARTLEY PHARMD CANDIDATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2020
Last Update Date: 10/04/2020
Certification Date: 10/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 FLETCHER HILL RD
WAMPUM PA
16157-7114
US

IV. Provider business mailing address

1606 FLETCHER HILL RD
WAMPUM PA
16157-7114
US

V. Phone/Fax

Practice location:
  • Phone: 724-971-5298
  • Fax:
Mailing address:
  • Phone: 724-971-5298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPI122142
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: