MEDICARE: DR. JONATHAN CALVERT FEATHERS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P2201X	Ambulatory Care Pharmacist	RP450077	PA
2	183500000X	Pharmacist	RP450077	PA

General Provider Information

NPI Number	:	1104415504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN CALVERT FEATHERS PHARMD

Provider Business Mailing Address
First Line	:	315 N 12TH ST APT 401
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-1217
Country	:	US
Telephone Number	:	304-481-9957
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 SCHEIVERT AVE
Second Line	:
City	:	ASTON
State	:	PA
Zip	:	19014-2762
Country	:	US
Telephone Number	:	610-494-1445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2021
Last Update Date	:	01/12/2021

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