Healthcare Provider Details

I. General information

NPI: 1356576805
Provider Name (Legal Business Name): JOHN DENNIS SOKSO JR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 SQUIRE LN
LITITZ PA
17543-7610
US

IV. Provider business mailing address

340 SQUIRE LN
LITITZ PA
17543-7610
US

V. Phone/Fax

Practice location:
  • Phone: 717-581-5232
  • Fax:
Mailing address:
  • Phone: 717-581-5232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP039218L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: