Provider Demographics
NPI:1265092159
Name:SPENCER, EMILY JORDAN (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:JORDAN
Last Name:SPENCER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 FORBES AVENUE, FORBES TOWER-PLAZA LEVEL SUITE 140
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 BURR AVE APT 416
Practice Address - Street 2:
Practice Address - City:GRANDVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:43212-3584
Practice Address - Country:US
Practice Address - Phone:724-799-1103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH03440967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program