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NPI Code Detail

MEDICARE: SUSAN ANNETTE HILDEBRAN RPH

MEDICARE: SUSAN ANNETTE HILDEBRAN RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRP039015LPA

General Provider Information

NPI Number : 1568052769
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ANNETTE HILDEBRAN RPH
Provider Business Mailing Address
First Line : PO BOX 105
Second Line :
City : SHEAKLEYVILLE
State : PA
Zip : 16151-0105
Country : US
Telephone Number : 724-699-2878
Fax Number : 724-450-7062
Provider Business Practice Location Address
First Line : 631 N BROAD STREET EXT
Second Line :
City : GROVE CITY
State : PA
Zip : 16127-4603
Country : US
Telephone Number : 724-450-7060
Fax Number : 724-450-7062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2021
Last Update Date : 01/21/2021

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Directions to “ SUSAN ANNETTE HILDEBRAN RPH” Practice Location

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