MEDICARE: MR. JONATHAN F VALENTINO RPH

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	3336C0003X	Community/Retail Pharmacy	RP041839L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RP041839L	OTHER	PA	LICENSE

General Provider Information

NPI Number	:	1841918216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JONATHAN F VALENTINO RPH

Provider Business Mailing Address
First Line	:	300 STEIN RD
Second Line	:
City	:	CHICORA
State	:	PA
Zip	:	16025-3424
Country	:	US
Telephone Number	:	724-496-6787
Fax Number	:

Provider Business Practice Location Address
First Line	:	937 E JEFFERSON ST
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-2002
Country	:	US
Telephone Number	:	724-285-3693
Fax Number	:	724-285-4186

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

Provider Enumeration Date	:	08/21/2022
Last Update Date	:	08/21/2022

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