Provider Demographics
NPI:1043107014
Name:JORDAN, SONIA MARIE (RPH)
Entity type:Individual
Prefix:MS
First Name:SONIA
Middle Name:MARIE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:STEWARTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17363-4014
Mailing Address - Country:US
Mailing Address - Phone:215-284-9330
Mailing Address - Fax:
Practice Address - Street 1:65 E FORREST AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1402
Practice Address - Country:US
Practice Address - Phone:717-235-7720
Practice Address - Fax:717-235-2575
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043032R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist