Provider Demographics
NPI:1336508761
Name:PEPPER, JENNIFER (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:PEPPER
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 1:121 SULLIVAN ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:PA
Mailing Address - Zip Code:17724-1733
Mailing Address - Country:US
Mailing Address - Phone:570-673-4372
Mailing Address - Fax:570-673-7247
Practice Address - Street 1:121 SULLIVAN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:PA
Practice Address - Zip Code:17724-1733
Practice Address - Country:US
Practice Address - Phone:570-673-4372
Practice Address - Fax:570-673-7247
Is Sole Proprietor?:No
Enumeration Date:2016-02-13
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437781183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist