MEDICARE: JOSEPH FRANCIS KERRIGAN JR.

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	183500000X	Pharmacist	RP029020L	PA
2	183500000X	Pharmacist	RPI006016	PA

General Provider Information

NPI Number	:	1366611147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH FRANCIS KERRIGAN JR.

Provider Business Mailing Address
First Line	:	1568 CHESTER PIKE
Second Line	:	SHOPRITE OF EDDYSTONE
City	:	EDDYSTONE
State	:	PA
Zip	:	19022-1338
Country	:	US
Telephone Number	:	610-471-0360
Fax Number	:	610-471-0362

Provider Business Practice Location Address
First Line	:	1568 CHESTER PIKE
Second Line	:	SHOPRITE OF EDDYSTONE
City	:	EDDYSTONE
State	:	PA
Zip	:	19022-1338
Country	:	US
Telephone Number	:	610-471-0360
Fax Number	:	610-471-0362

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

Provider Enumeration Date	:	02/26/2008
Last Update Date	:	04/23/2016

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