Provider Demographics
NPI:1063685923
Name:CHILSON, JEFF A (RPH)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:A
Last Name:CHILSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:REEDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17084-9775
Mailing Address - Country:US
Mailing Address - Phone:717-667-0194
Mailing Address - Fax:
Practice Address - Street 1:10180 US HIGHWAY 522 S
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-8938
Practice Address - Country:US
Practice Address - Phone:717-242-6206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044090L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist