Provider Demographics
NPI:1013203223
Name:JEFFREY, WILLIAM ANTHONY (BSC (PHARM);RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ANTHONY
Last Name:JEFFREY
Suffix:
Gender:M
Credentials:BSC (PHARM);RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5035 LINCOLN WAY E
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17222-1045
Mailing Address - Country:US
Mailing Address - Phone:717-352-3850
Mailing Address - Fax:
Practice Address - Street 1:5035 LINCOLN WAY E
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17222-1045
Practice Address - Country:US
Practice Address - Phone:717-352-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032352L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist