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General NPI Number Information
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NPI Number | 1720418106
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Entity Type | Individual
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Provider Name | JILL DEZENHALL RPH
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Gender | Female
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Dates
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Enumeration Date | 11/20/2013
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 251 N BROADWAY
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City | PENNSVILLE
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State | NJ
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Zip | 08070-1200
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Country | US
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Telephone | 856-678-4378
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Fax | 856-678-4421
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Provider Business Mailing Address
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Address Line | 251 N BROADWAY
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City | PENNNSVILLE
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State | NJ
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Zip | 08070
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Country | US
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Telephone | 856-678-4378
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Fax | 856-678-4421
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RI015868
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License Number State | NJ
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