Healthcare Provider Details

I. General information

NPI: 1417969403
Provider Name (Legal Business Name): JBDL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CHESTER PIKE STE C
SHARON HILL PA
19079-1400
US

IV. Provider business mailing address

PO BOX 7
SHARON HILL PA
19079-0007
US

V. Phone/Fax

Practice location:
  • Phone: 610-586-3100
  • Fax: 610-586-6926
Mailing address:
  • Phone: 610-586-3100
  • Fax: 610-586-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP481313
License Number StatePA

VIII. Authorized Official

Name: JOHN CARAMANICO
Title or Position: PHARMACIST
Credential:
Phone: 610-586-3100