Provider Demographics
NPI:1912239138
Name:SAUL, JEFFREY VINCENT (RPH)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:VINCENT
Last Name:SAUL
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 1:2308 FOREST HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1065
Mailing Address - Country:US
Mailing Address - Phone:717-652-6562
Mailing Address - Fax:
Practice Address - Street 1:5050 JONESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2921
Practice Address - Country:US
Practice Address - Phone:717-652-9190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP1000140183500000X
PARP027234L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist