Provider Demographics
NPI:1679759435
Name:PERROT, JEAN VINCENT (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:VINCENT
Last Name:PERROT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 RT 6 AND 209
Mailing Address - Street 2:722 RT 6 AND 209
Mailing Address - City:MATAMORAS
Mailing Address - State:PA
Mailing Address - Zip Code:10963-0000
Mailing Address - Country:US
Mailing Address - Phone:570-491-5019
Mailing Address - Fax:570-491-5437
Practice Address - Street 1:722 RT 6 AND 209
Practice Address - Street 2:722 RT 6 AND 209
Practice Address - City:MATAMORAS
Practice Address - State:PA
Practice Address - Zip Code:10963-0000
Practice Address - Country:US
Practice Address - Phone:570-491-5019
Practice Address - Fax:570-491-5437
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439737183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist