Active NPI
Christopher Michael Kovalyak, RPH.
- Pharmacist
- Du Bois, PA
National Provider Identifier
1134395403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP037499L
- Practice address
- 241 W Long Ave
Du Bois, PA 15801-2105 - Phone
- (814) 371-9320
- NPI assigned
- May 6, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | RP037499L | PA | Primary |
Addresses
Primary practice location
241 W Long Ave
Du Bois, PA 15801-2105
Mailing address
241 W Long Ave
Du Bois, PA 15801-2105
Phone (814) 371-9320
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RP037499L | Other | PA | PA STATE LICENSE |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP037499L | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210032000000",
"number": "1134395403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "241 W LONG AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158012105",
"telephone_number": "814-371-9320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "241 W LONG AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158012105",
"telephone_number": "814-371-9320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOVALYAK",
"first_name": "CHRISTOPHER",
"middle_name": "MICHAEL",
"credential": "RPH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-06",
"last_updated": "2008-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP037499L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA STATE LICENSE",
"identifier": "RP037499L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Du Bois, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.