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NPI Code Detail

MEDICARE: JACQUELYN LAURIE DEBATES PHARMD

MEDICARE: JACQUELYN LAURIE DEBATES 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
1183500000XPharmacistRP453284PA

General Provider Information

NPI Number : 1780286211
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELYN LAURIE DEBATES PHARMD
Provider Business Mailing Address
First Line : 355 LINCOLN AVE
Second Line :
City : EAST STROUDSBURG
State : PA
Zip : 18301-2814
Country : US
Telephone Number : 570-424-8612
Fax Number : 570-424-8706
Provider Business Practice Location Address
First Line : 355 LINCOLN AVE
Second Line :
City : EAST STROUDSBURG
State : PA
Zip : 18301-2814
Country : US
Telephone Number : 570-424-8612
Fax Number : 570-424-8706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2020
Last Update Date : 11/10/2020

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Directions to “ JACQUELYN LAURIE DEBATES PHARMD” Practice Location

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