Healthcare Provider Details

I. General information

NPI: 1093028615
Provider Name (Legal Business Name): JOHN W HAMILL III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2010
Last Update Date: 07/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 CHICHESTER AVE
UPPER CHICHESTER PA
19061-3251
US

IV. Provider business mailing address

723 WESTCROFT PL
WEST CHESTER PA
19382-7430
US

V. Phone/Fax

Practice location:
  • Phone: 610-494-2770
  • Fax:
Mailing address:
  • Phone: 610-399-3730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP034146L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: