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General NPI Number Information
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NPI Number | 1386892669
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Entity Type | Individual
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Provider Name | BRIAN JAMES HEINTZELMAN PHARMD;RPH
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Gender | Male
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Dates
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Enumeration Date | 08/29/2008
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Last Update Date | 08/29/2008
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Provider Practice Location Address
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Address Line | 777 RURAL AVE SL2 EAST
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-3109
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Country | US
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Telephone | 570-321-2818
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Fax | 570-321-2819
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Provider Business Mailing Address
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Address Line | 91 BRENTWOOD CIR
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City | BLOOMSBURG
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State | PA
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Zip | 17815-7739
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Country | US
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Telephone | 570-898-0993
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Fax | 570-321-2819
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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 | RP441016
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License Number State | PA
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