Provider Demographics
NPI:1740882364
Name:CONWAY, JEANINE ELIZABETH (PHARM D)
Entity type:Individual
Prefix:
First Name:JEANINE
Middle Name:ELIZABETH
Last Name:CONWAY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3477 LANCASTER AVE
Mailing Address - Street 2:3477 E LANCASTER HWY
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372
Mailing Address - Country:US
Mailing Address - Phone:610-383-5461
Mailing Address - Fax:610-383-7924
Practice Address - Street 1:3477 LANCASTER AVE
Practice Address - Street 2:3477 E LANCASTER HWY
Practice Address - City:THORNDALE
Practice Address - State:PA
Practice Address - Zip Code:19372
Practice Address - Country:US
Practice Address - Phone:610-383-5461
Practice Address - Fax:610-383-7924
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist