Provider Demographics
NPI:1255620043
Name:FOSTER, JOHN WILLIAM
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:FOSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:WILLIAM
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:278 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-8119
Mailing Address - Country:US
Mailing Address - Phone:814-696-3382
Mailing Address - Fax:814-696-3382
Practice Address - Street 1:3331 PLEASANT VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4311
Practice Address - Country:US
Practice Address - Phone:814-942-1081
Practice Address - Fax:814-942-6049
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP028026L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist