Provider Demographics
NPI:1275827313
Name:HUNTINGTON, JILL (PHARMD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:HUNTINGTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 HUNTINGTON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-7313
Mailing Address - Country:US
Mailing Address - Phone:319-550-6749
Mailing Address - Fax:
Practice Address - Street 1:3400 EDGEWOOD RD SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-7214
Practice Address - Country:US
Practice Address - Phone:319-396-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist