Healthcare Provider Details

I. General information

NPI: 1194138743
Provider Name (Legal Business Name): JEFFREY VINOSKY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 06/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 N 6TH ST
READING PA
19601-3012
US

IV. Provider business mailing address

203 ERNST RD
MOHRSVILLE PA
19541-9556
US

V. Phone/Fax

Practice location:
  • Phone: 610-374-6282
  • Fax:
Mailing address:
  • Phone: 267-394-1983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP447380
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: