David Jack, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP033586L Issued in PA

Practice address

130 Enterprise Dr
Walgreens Specialty Pharmacy
Pittsburgh, PA 15275-1213

Phone

(412) 413-8041

Fax

(877) 231-8302

NPI assigned

Apr 6, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1942664974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 ENTERPRISE DR",
            "address_2": "WALGREENS SPECIALTY PHARMACY",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751213",
            "telephone_number": "412-413-8041",
            "fax_number": "877-231-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 ENTERPRISE DR",
            "address_2": "WALGREENS SPECIALTY PHARMACY",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751213",
            "telephone_number": "412-413-8041",
            "fax_number": "877-231-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP033586L",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0008819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Marie Jablonski
• Jack D Spencer,DMD
• Jack Demos, M.D., Inc.
• Jack L Malvin Dental Associates, PC
• Danielle N. Jack
• Jessica Paige Jack, MSW
• Kerri A Jack, PA
• Lauren Jack
• Katie Jackley, PA-C
• Larissa Ann Jackline, CRNP

• Pharmacist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.