Provider Demographics
NPI:1467126573
Name:FIRESTINE, JULIA LAUREN (PHARMACY INTERN)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:LAUREN
Last Name:FIRESTINE
Suffix:
Gender:F
Credentials:PHARMACY INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 E PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:BOYERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19512-1125
Mailing Address - Country:US
Mailing Address - Phone:610-369-3888
Mailing Address - Fax:
Practice Address - Street 1:2 E PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:BOYERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19512-1125
Practice Address - Country:US
Practice Address - Phone:601-369-3888
Practice Address - Fax:610-639-3886
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPI124483183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician