Healthcare Provider Details

I. General information

NPI: 1952623332
Provider Name (Legal Business Name): ANN MARIE CHRISTINA VIOLA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2010
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 WILKES-BARRE TWP. BLVD.
WILKES-BARRE PA
18702-6194
US

IV. Provider business mailing address

910 WILKES-BARRE TWP. BLVD. KMART #3268
WILKES-BARRE PA
18702-6194
US

V. Phone/Fax

Practice location:
  • Phone: 570-954-1884
  • Fax: 847-747-1479
Mailing address:
  • Phone: 570-954-1884
  • Fax: 847-747-1479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP038532L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: