Provider Demographics
NPI:1518560317
Name:SALVEY, JEANETTE KATHLEEN
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:KATHLEEN
Last Name:SALVEY
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 1:3 S PENNELL RD
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5258
Mailing Address - Country:US
Mailing Address - Phone:610-575-7200
Mailing Address - Fax:
Practice Address - Street 1:3 S PENNELL RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5258
Practice Address - Country:US
Practice Address - Phone:610-565-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043903L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP043903LOtherPA STATE BOARD OF PHARMACY