Healthcare Provider Details

I. General information

NPI: 1881731354
Provider Name (Legal Business Name): JEFFREY CARL PITCHER R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 MAIN ST
WYALUSING PA
18853
US

IV. Provider business mailing address

500 THIRD STREET
TOWANDA PA
18848
US

V. Phone/Fax

Practice location:
  • Phone: 570-746-1004
  • Fax: 570-746-9470
Mailing address:
  • Phone: 570-265-2515
  • Fax: 570-746-9470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP039151L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: