Provider Demographics
NPI:1104415504
Name:FEATHERS, JONATHAN CALVERT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CALVERT
Last Name:FEATHERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N 12TH ST APT 401
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1217
Mailing Address - Country:US
Mailing Address - Phone:304-481-9957
Mailing Address - Fax:
Practice Address - Street 1:10 SCHEIVERT AVE
Practice Address - Street 2:
Practice Address - City:ASTON
Practice Address - State:PA
Practice Address - Zip Code:19014-2762
Practice Address - Country:US
Practice Address - Phone:610-494-1445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4500771835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care