Active NPI
Andrea Marie Patrick, PHARM.D. , R.PH.
- Pharmacist
- White Haven, PA
National Provider Identifier
1124235403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP045208-L
- Practice address
- 2 Main Street
White Haven, PA 18661 - Phone
- (570) 449-9519
- Fax
- (570) 443-4408
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP045208-L | PA | Primary |
Addresses
Primary practice location
2 Main Street
White Haven, PA 18661
Mailing address
2 Main Street
White Haven, PA 18661
Phone (570) 449-9519
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP045208-L | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124235403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MAIN STREET",
"city": "WHITE HAVEN",
"state": "PA",
"postal_code": "18661",
"telephone_number": "570-449-9519",
"fax_number": "570-443-4408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 MAIN STREET",
"city": "WHITE HAVEN",
"state": "PA",
"postal_code": "18661",
"telephone_number": "570-449-9519",
"fax_number": "570-443-4408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "ANDREA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHARM.D. , R.PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP045208-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Haven, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.