Provider Demographics
NPI:1477784353
Name:SKOVIRA, JILL
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:SKOVIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WYNDHAM LN
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-2420
Mailing Address - Country:US
Mailing Address - Phone:610-594-8816
Mailing Address - Fax:
Practice Address - Street 1:200 MILL ROAD
Practice Address - Street 2:STE. 100
Practice Address - City:OAKS
Practice Address - State:PA
Practice Address - Zip Code:19456
Practice Address - Country:US
Practice Address - Phone:610-650-3927
Practice Address - Fax:610-650-3927
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038624L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist