Provider Demographics
NPI:1053846972
Name:D'AMICO, JILL (RPH)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:D'AMICO
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 1:7545 SYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-9735
Mailing Address - Country:US
Mailing Address - Phone:419-841-6468
Mailing Address - Fax:419-843-7053
Practice Address - Street 1:7545 SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9735
Practice Address - Country:US
Practice Address - Phone:419-841-6468
Practice Address - Fax:419-843-7053
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03225248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist