Provider Demographics
NPI:1407919244
Name:LEMON, JEFFREY PHILLIP (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:PHILLIP
Last Name:LEMON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 RIVERSIDE PLZ
Mailing Address - Street 2:
Mailing Address - City:BLOSSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16912-1137
Mailing Address - Country:US
Mailing Address - Phone:570-638-2820
Mailing Address - Fax:570-638-3642
Practice Address - Street 1:2 RIVERSIDE PLZ
Practice Address - Street 2:
Practice Address - City:BLOSSBURG
Practice Address - State:PA
Practice Address - Zip Code:16912-1137
Practice Address - Country:US
Practice Address - Phone:570-638-2820
Practice Address - Fax:570-638-3642
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030125L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP030125LOtherPHARMACIST LICENSE