Provider Demographics
NPI:1548443914
Name:MAYER, JOSEPH RAYMOND (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:RAYMOND
Last Name:MAYER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:EVANS CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16033-7833
Mailing Address - Country:US
Mailing Address - Phone:724-538-3669
Mailing Address - Fax:724-538-8738
Practice Address - Street 1:545 PROSPECT RD
Practice Address - Street 2:
Practice Address - City:EVANS CITY
Practice Address - State:PA
Practice Address - Zip Code:16033-7833
Practice Address - Country:US
Practice Address - Phone:724-538-3669
Practice Address - Fax:724-538-8738
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-09
Last Update Date:2007-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034408R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist