MEDICARE: JESSICA CANE

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	RP441140	PA

General Provider Information

NPI Number	:	1700247616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA CANE

Provider Business Mailing Address
First Line	:	1400 E PASSYUNK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-5611
Country	:	US
Telephone Number	:	215-551-3321
Fax Number	:	215-551-3449

Provider Business Practice Location Address
First Line	:	1400 E PASSYUNK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-5611
Country	:	US
Telephone Number	:	215-551-3321
Fax Number	:	215-551-3449

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

Provider Enumeration Date	:	03/19/2016
Last Update Date	:	03/19/2016

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Directions to “ JESSICA CANE ” Practice Location

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