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General NPI Number Information
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NPI Number | 1942982343
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Entity Type | Individual
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Provider Name | JORDAN OLIVIA FYOCK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2023
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 598 GALLERIA DR
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City | JOHNSTOWN
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State | PA
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Zip | 15904-8900
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Country | US
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Telephone | 814-943-8164
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Fax |
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Provider Business Mailing Address
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Address Line | 1398 OLD FORBES RD
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City | STOYSTOWN
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State | PA
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Zip | 15563-8765
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Country | US
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Telephone | 814-659-3676
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Fax |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RP456943
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License Number State | PA
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