Provider Demographics
NPI:1104458363
Name:SEDELMYER, JEFFREY PAUL (RPH)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:PAUL
Last Name:SEDELMYER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5349 GARDNER DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-3003
Mailing Address - Country:US
Mailing Address - Phone:814-823-2855
Mailing Address - Fax:
Practice Address - Street 1:5349 GARDNER DR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-3003
Practice Address - Country:US
Practice Address - Phone:814-823-2855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045040R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist