Provider Demographics
NPI:1558859876
Name:DROGALIS, JEROME EDWARD (RPH)
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:EDWARD
Last Name:DROGALIS
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 1:112 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:DURYEA
Mailing Address - State:PA
Mailing Address - Zip Code:18642-1525
Mailing Address - Country:US
Mailing Address - Phone:570-313-1137
Mailing Address - Fax:
Practice Address - Street 1:3913 HARTZDALE DR STE 1306
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-7845
Practice Address - Country:US
Practice Address - Phone:717-766-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031148L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist