Provider Demographics
NPI:1225359888
Name:STAPLETON, JEANINE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JEANINE
Middle Name:
Last Name:STAPLETON
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 1:115 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1212
Mailing Address - Country:US
Mailing Address - Phone:856-489-0601
Mailing Address - Fax:
Practice Address - Street 1:2555 PENNINGTON RD
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-3216
Practice Address - Country:US
Practice Address - Phone:609-737-0606
Practice Address - Fax:609-281-9002
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02720500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist