Individual
CAROLYN BACICA-FAHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1530 COWPATH RD, HATFIELD, PA 19440-3101
(215) 361-2542
(215) 361-2631
Mailing address
1530 COWPATH RD, HATFIELD, PA 19440-3101
(215) 361-2542
(215) 361-2631
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP038860L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015538870015
—
PA
01
—
203622903
TAX ID
PA
01
—
3988396
NABP#
PA
01
—
PP481736
STATE LICENSE
PA
Enumeration date
09/21/2022
Last updated
09/21/2022
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