Provider Demographics
NPI:1710375282
Name:WRIGHT, JEFFREY BERNARD (RPH)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:BERNARD
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 JUNE DR
Mailing Address - Street 2:
Mailing Address - City:ROARING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:16673-2316
Mailing Address - Country:US
Mailing Address - Phone:814-224-5553
Mailing Address - Fax:814-224-5827
Practice Address - Street 1:94 JUNE DR
Practice Address - Street 2:
Practice Address - City:ROARING SPRING
Practice Address - State:PA
Practice Address - Zip Code:16673-2316
Practice Address - Country:US
Practice Address - Phone:814-224-5553
Practice Address - Fax:814-224-5827
Is Sole Proprietor?:No
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP029225L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist