Provider Demographics
NPI:1114317963
Name:MCFALLS, JACKI DAWN
Entity Type:Individual
Prefix:
First Name:JACKI
Middle Name:DAWN
Last Name:MCFALLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 EAGLEVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-3012
Mailing Address - Country:US
Mailing Address - Phone:484-713-0151
Mailing Address - Fax:484-713-0161
Practice Address - Street 1:180 EAGLEVIEW BLVD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-3012
Practice Address - Country:US
Practice Address - Phone:484-713-0151
Practice Address - Fax:484-713-0161
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician