Provider Demographics
NPI:1356970552
Name:ROTHENBERGER, JENNIFER D (RPH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:D
Last Name:ROTHENBERGER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:PA
Mailing Address - Zip Code:19560-9757
Mailing Address - Country:US
Mailing Address - Phone:610-413-3815
Mailing Address - Fax:
Practice Address - Street 1:5370 ALLENTOWN PIKE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:PA
Practice Address - Zip Code:19560-1200
Practice Address - Country:US
Practice Address - Phone:610-939-0616
Practice Address - Fax:610-939-0614
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043211L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist