Provider Demographics
NPI:1376867192
Name:OBRIEN, JOHN J (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:OBRIEN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-5909
Mailing Address - Country:US
Mailing Address - Phone:215-710-7427
Mailing Address - Fax:215-710-7434
Practice Address - Street 1:834 CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-5909
Practice Address - Country:US
Practice Address - Phone:215-710-7427
Practice Address - Fax:215-710-7434
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP027693L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist