Individual
ELLEN P KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
509 POPLAR ST, MAYFIELD, PA 18433-1800
(570) 876-0740
(570) 876-3946
Mailing address
509 POPLAR ST, MAYFIELD, PA 18433-1800
(570) 876-3946
(570) 876-3946
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP031370L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008734770001
—
PA
Enumeration date
02/01/2007
Last updated
07/09/2007
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