Provider Demographics
NPI:1033568597
Name:WINTERS, JAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:WINTERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 CHEMICAL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1708
Mailing Address - Country:US
Mailing Address - Phone:800-548-9903
Mailing Address - Fax:610-941-0742
Practice Address - Street 1:4000 CHEMICAL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1708
Practice Address - Country:US
Practice Address - Phone:800-548-9903
Practice Address - Fax:610-941-0742
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP437995OtherPHARMACY LICENSE