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General NPI Number Information
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NPI Number | 1386117984
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Entity Type | Individual
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Provider Name | GURDIP SINGH SIDHU PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 1550 COLUMBIA AVE
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City | LANCASTER
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State | PA
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Zip | 17603-4527
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Country | US
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Telephone | 717-394-2580
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Fax |
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Provider Business Mailing Address
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Address Line | 25 WELSH DR
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City | LANCASTER
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State | PA
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Zip | 17601-2332
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP453085
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License Number State | PA
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