Provider Demographics
NPI:1851992671
Name:ANGIOLILLO, ANDREW VINCENT JR (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:VINCENT
Last Name:ANGIOLILLO
Suffix:JR
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 1:2670 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2302
Mailing Address - Country:US
Mailing Address - Phone:610-631-8134
Mailing Address - Fax:610-631-8488
Practice Address - Street 1:2670 EGYPT RD
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-2302
Practice Address - Country:US
Practice Address - Phone:610-631-8134
Practice Address - Fax:610-631-8488
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044153L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist