Provider Demographics
NPI:1700370533
Name:MAO, JACK ZHIXIANG (PHARMD, RPH, BS)
Entity Type:Individual
Prefix:MR
First Name:JACK
Middle Name:ZHIXIANG
Last Name:MAO
Suffix:
Gender:M
Credentials:PHARMD, RPH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BRANDYWINE CT
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1161
Mailing Address - Country:US
Mailing Address - Phone:215-837-9061
Mailing Address - Fax:
Practice Address - Street 1:200 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-2120
Practice Address - Country:US
Practice Address - Phone:215-497-9231
Practice Address - Fax:215-497-9237
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030672183500000X
PARP452273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist