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NPI Code Detail

MEDICARE: JESSICA MACE

MEDICARE: JESSICA MACE
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
1183500000XPharmacistRP445089PA

General Provider Information

NPI Number : 1578903431
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MACE
Provider Business Mailing Address
First Line : 3913 HARTZDALE DR STE 1306
Second Line :
City : CAMP HILL
State : PA
Zip : 17011-7845
Country : US
Telephone Number : 717-695-9082
Fax Number :
Provider Business Practice Location Address
First Line : 3913 HARTZDALE DR STE 1306
Second Line :
City : CAMP HILL
State : PA
Zip : 17011-7845
Country : US
Telephone Number : 717-695-9082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2013
Last Update Date : 06/25/2013

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Directions to “ JESSICA MACE ” Practice Location

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