Provider Demographics
NPI:1538487780
Name:MITCHELL, DAVID JOHN (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOHN
Last Name:MITCHELL
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 1:2222 FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4423
Mailing Address - Country:US
Mailing Address - Phone:732-899-8971
Mailing Address - Fax:
Practice Address - Street 1:2222 FOSTER RD
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-4423
Practice Address - Country:US
Practice Address - Phone:732-899-8971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02393400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist