Jaison John
Individual provider Active NPI Pharmacist · Glenolden, PA
NPI 1467905448 · NPPES record last updated Jul 26, 2016
Key facts
- NPI
- 1467905448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP450299 (PA)
- Practice address
- 150 N Macdade Blvd
Glenolden, PA 19036-1224 - Phone
- (610) 586-5224
- NPI assigned
- Jul 26, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP450299 | PA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP450299 | PA | Yes |
Addresses
Primary practice location
150 N Macdade Blvd
Glenolden, PA 19036-1224
Mailing address
303 Palmer Dr
Philadelphia, PA 19115-1023
Other providers in Glenolden, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.