Most Relevant Information
Provider Data
| NPI Number: | 1003465451 |
| Provider Name: | PATRICK J SOUTHALL RPH |
| Entity Type: | Individual |
| Taxonomy Code: | 1835P0018X |
| Specialty: | Pharmacist |
| License Number: | 10278 |
Most Important Dates
| Enumeration Date: | 09/09/2019 |
| Last Updated: | 09/09/2019 |
Provider Practice Location
1250 PATROL RD
CHARLESTOWN
IN
471118670
Practice Location Phone/Fax
| Phone: | 8124062299 |
| Fax: | 8124062299 |
Provider Mailing Location
1250 PATROL RD
CHARLESTOWN
IN
471118670
Provider Mailing Phone/Fax
| Phone: | 8124062299 |
| Fax: |