MEDICARE: KRISTA CHATWOOD PHARMD, MBA

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
1	183500000X	Pharmacist	RP455186	PA

General Provider Information

NPI Number	:	1851986665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA CHATWOOD PHARMD, MBA

Provider Business Mailing Address
First Line	:	400 LAKEMONT PARK BLVD STE 100
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-5967
Country	:	US
Telephone Number	:	814-656-6030
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 LAKEMONT PARK BLVD STE 100
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-5967
Country	:	US
Telephone Number	:	814-656-6030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2021
Last Update Date	:	03/13/2026

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