Provider Demographics
NPI:1316237134
Name:JONES, DAVID R (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:R
Last Name:JONES
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 1:501 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WHITE HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:18661-1513
Mailing Address - Country:US
Mailing Address - Phone:570-443-9519
Mailing Address - Fax:570-443-4408
Practice Address - Street 1:501 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:WHITE HAVEN
Practice Address - State:PA
Practice Address - Zip Code:18661-1513
Practice Address - Country:US
Practice Address - Phone:570-443-9519
Practice Address - Fax:570-443-4408
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040189L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist