Jack Zhixiang Mao, PHARMD, RPH, BS

Key facts

NPI

1700370533

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

RP452273 (PA)

Practice address

504 S Oxford Valley Rd
Fairless Hills, PA 19030-2615

Phone

(215) 945-5720

NPI assigned

Jun 15, 2018

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

Credentials

Bachelor of Science, Doctor of Pharmacy, Registered Pharmacist

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 27, 2025.

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1700370533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 CRIMSON CT",
            "city": "WARRINGTON",
            "state": "PA",
            "postal_code": "189762462",
            "telephone_number": "215-837-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 S OXFORD VALLEY RD",
            "city": "FAIRLESS HILLS",
            "state": "PA",
            "postal_code": "190302615",
            "telephone_number": "215-945-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAO",
        "first_name": "JACK",
        "middle_name": "ZHIXIANG",
        "name_prefix": "Mr.",
        "credential": "PHARMD, RPH, BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH030672",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP452273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairless Hills, PA

• Nuofei Lin
• Phyllis Loduca
• Sean Loose, MD
• Kelly Lyons, LPN
• Wendy Robin Mailman, M.D.
• Arun Kumar Mathur, DMD PHD
• Kimberly Ann McAllister, CRNP
• Stephen Edward McCormick
• Melissa McDonnell
• Shawn Robert McKay

All providers in Fairless Hills, PA · Pharmacist in Pennsylvania