Provider Demographics
NPI:1629450044
Name:WOLFE, JEREMY CHARLES (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:CHARLES
Last Name:WOLFE
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1250
Mailing Address - Country:US
Mailing Address - Phone:215-536-1800
Mailing Address - Fax:
Practice Address - Street 1:345 W BROAD ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1250
Practice Address - Country:US
Practice Address - Phone:215-536-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist