Provider Demographics
NPI:1932867223
Name:MUSCALUS, JODI LYN
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:LYN
Last Name:MUSCALUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:LYN
Other - Last Name:WITMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2471 ZELL CT
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-6816
Mailing Address - Country:US
Mailing Address - Phone:717-712-8092
Mailing Address - Fax:
Practice Address - Street 1:2471 ZELL CT
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-6816
Practice Address - Country:US
Practice Address - Phone:717-712-8092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033790L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist