Provider Demographics
NPI:1619139953
Name:DEVINE, JOHNNA L (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JOHNNA
Middle Name:L
Last Name:DEVINE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:JOHNNA
Other - Middle Name:L
Other - Last Name:HOMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2224 ALTAVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-1602
Mailing Address - Country:US
Mailing Address - Phone:412-344-2255
Mailing Address - Fax:
Practice Address - Street 1:330 S 9TH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1266
Practice Address - Country:US
Practice Address - Phone:412-697-4880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist