Most Relevant Information
Provider Data
| NPI Number: | 1003364449 |
| Provider Name: | STACY KANDRAC |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | RP451064 |
Most Important Dates
| Enumeration Date: | 09/14/2016 |
| Last Updated: | 09/14/2016 |
Provider Practice Location
1000 E MOUNTAIN BLVD
WILKES BARRE
PA
187110027
Practice Location Phone/Fax
| Phone: | 5708087701 |
| Fax: |
Provider Mailing Location
1000 E MOUNTAIN BLVD
WILKES BARRE
PA
187110027
Provider Mailing Phone/Fax
| Phone: | 5708087701 |
| Fax: |