Provider Demographics
NPI:1548697717
Name:DAUGHERTY, ANDREA M (RPH)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:M
Last Name:DAUGHERTY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NOBLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-1230
Mailing Address - Country:US
Mailing Address - Phone:412-325-6500
Mailing Address - Fax:877-231-8302
Practice Address - Street 1:500 NOBLESTOWN RD
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-1230
Practice Address - Country:US
Practice Address - Phone:412-325-6500
Practice Address - Fax:877-231-8302
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041076L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist