Healthcare Provider Details

I. General information

NPI: 1477762102
Provider Name (Legal Business Name): JULIE JANELLEN GWIN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LANCASTER AVE INPATIENT PHARMACY DEPARTMENT - GROUND FLOOR
WYNNEWOOD PA
19096-3450
US

IV. Provider business mailing address

100 E LANCASTER AVE INPATIENT PHARMACY DEPARTMENT - GROUND FLOOR
WYNNEWOOD PA
19096-3450
US

V. Phone/Fax

Practice location:
  • Phone: 610-645-3104
  • Fax: 610-645-8098
Mailing address:
  • Phone: 610-645-3104
  • Fax: 610-645-8098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP036463R
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: