Healthcare Provider Details

I. General information

NPI: 1114334315
Provider Name (Legal Business Name): JANINE MARIA NOSS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2014
Last Update Date: 07/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 W LANCASTER AVE PHARMACY
ARDMORE PA
19003-1401
US

IV. Provider business mailing address

169 W LANCASTER AVE PHARMACY
ARDMORE PA
19003-1401
US

V. Phone/Fax

Practice location:
  • Phone: 610-649-7150
  • Fax: 610-649-3391
Mailing address:
  • Phone: 610-649-7150
  • Fax: 610-649-3391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP448858
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: