Provider Demographics
NPI:1932196466
Name:SOLES, JERRY SHAWN (RPH)
Entity Type:Individual
Prefix:MR
First Name:JERRY
Middle Name:SHAWN
Last Name:SOLES
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 1:37 SADDLEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-9789
Mailing Address - Country:US
Mailing Address - Phone:724-853-3254
Mailing Address - Fax:724-853-3258
Practice Address - Street 1:730 E PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2637
Practice Address - Country:US
Practice Address - Phone:724-853-3254
Practice Address - Fax:724-853-3258
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039425L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist