Provider Demographics
NPI:1437472321
Name:PANZIK, LORA ANN (PHRAM D RPH)
Entity type:Individual
Prefix:DR
First Name:LORA
Middle Name:ANN
Last Name:PANZIK
Suffix:
Gender:F
Credentials:PHRAM D RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 WILKES BARRE
Mailing Address - Street 2:
Mailing Address - City:WILKES- BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-821-6190
Mailing Address - Fax:
Practice Address - Street 1:2150 WILKES BARRE TOWNSHIP MARKETPLACE
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702
Practice Address - Country:US
Practice Address - Phone:570-821-6190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist