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General NPI Number Information
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NPI Number | 1073142378
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Entity Type | Individual
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Provider Name | ERIN DORMAN
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Gender | Female
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 8931 ROUTE 30
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City | NORTH HUNTINGDON
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State | PA
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Zip | 15642-2704
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Country | US
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Telephone | 724-863-5398
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Fax |
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Provider Business Mailing Address
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Address Line | 105 SUMMIT ST
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City | PENN
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State | PA
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Zip | 15675-9508
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Country | US
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Telephone | 724-875-8440
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 350101060350931
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License Number State | PA
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