Provider Demographics
NPI:1215530928
Name:JIRLES, PAUL (RPH)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:JIRLES
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:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:LORE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43755-0021
Mailing Address - Country:US
Mailing Address - Phone:740-260-6550
Mailing Address - Fax:
Practice Address - Street 1:1116 WHEELING AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2508
Practice Address - Country:US
Practice Address - Phone:740-439-3502
Practice Address - Fax:740-439-6656
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032179293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy