Provider Demographics
NPI:1578070181
Name:MITCHELL, JODI (RPH)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 S PARK RD STE 1
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1150
Mailing Address - Country:US
Mailing Address - Phone:412-831-1333
Mailing Address - Fax:412-831-1991
Practice Address - Street 1:3400 S PARK RD STE 1
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1150
Practice Address - Country:US
Practice Address - Phone:412-831-1333
Practice Address - Fax:412-831-1991
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044818L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist