Individual provider Active NPI

Theresa M Jackovic, PHARM D

  • Pharmacist
  • Pleasant Hills, PA
National Provider Identifier
1962725606
Registry record updated Mar 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP046357 Issued in PA
Practice address
720 Clairton Blvd
Pleasant Hills, PA 15236-4517
Phone
(412) 653-7906
NPI assigned
Mar 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP046357 PA Primary

Addresses

Primary practice location

720 Clairton Blvd
Pleasant Hills, PA 15236-4517

Mailing address

4670 Old Boston Rd
Pittsburgh, PA 15227-1112
Phone (412) 526-1753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP046357PAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268092800000",
    "number": "1962725606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 OLD BOSTON RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152271112",
            "telephone_number": "412-526-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 CLAIRTON BLVD",
            "city": "PLEASANT HILLS",
            "state": "PA",
            "postal_code": "152364517",
            "telephone_number": "412-653-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKOVIC",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP046357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hills, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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.