Provider Demographics
NPI:1881731354
Name:PITCHER, JEFFREY CARL (RPH)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:CARL
Last Name:PITCHER
Suffix:
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 1:500 THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848
Mailing Address - Country:US
Mailing Address - Phone:570-265-2515
Mailing Address - Fax:570-746-9470
Practice Address - Street 1:137 MAIN ST
Practice Address - Street 2:
Practice Address - City:WYALUSING
Practice Address - State:PA
Practice Address - Zip Code:18853
Practice Address - Country:US
Practice Address - Phone:570-746-1004
Practice Address - Fax:570-746-9470
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039151L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist