MEDICARE: MRS. DONNA DRISCOLL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI02718800	NJ

General Provider Information

NPI Number	:	1033570023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA DRISCOLL PHARMD

Provider Business Mailing Address
First Line	:	515 BERLIN CROSS KEYS RD
Second Line	:
City	:	SICKLERVILLE
State	:	NJ
Zip	:	08081-4368
Country	:	US
Telephone Number	:	856-728-2189
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 BERLIN CROSS KEYS RD
Second Line	:
City	:	SICKLERVILLE
State	:	NJ
Zip	:	08081-4368
Country	:	US
Telephone Number	:	856-728-2189
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2016
Last Update Date	:	03/17/2016

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