Most Relevant Information
Provider Data
| NPI Number: | 1003206590 |
| Provider Name: | FATIMA JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 183700000X |
| Specialty: | Pharmacy Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/04/2015 |
| Last Updated: | 02/04/2015 |
Provider Practice Location
2527 SHOPPERS LANE, CHELTENHAM SQUARE MALL
PHILADELPHIA
PA
19150
Practice Location Phone/Fax
| Phone: | 2676283281 |
| Fax: | 2676283281 |
Provider Mailing Location
2527 SHOPPERS LANE, CHELTENHAM SQUARE MALL
PHILADELPHIA
PA
19150
Provider Mailing Phone/Fax
| Phone: | 2676283281 |
| Fax: | 2676283281 |