Provider Demographics
NPI:1841918216
Name:VALENTINO, JONATHAN F (RPH)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:F
Last Name:VALENTINO
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 1:300 STEIN RD
Mailing Address - Street 2:
Mailing Address - City:CHICORA
Mailing Address - State:PA
Mailing Address - Zip Code:16025-3424
Mailing Address - Country:US
Mailing Address - Phone:724-496-6787
Mailing Address - Fax:
Practice Address - Street 1:937 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2002
Practice Address - Country:US
Practice Address - Phone:724-285-3693
Practice Address - Fax:724-285-4186
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-21
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041839L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP041839LOtherLICENSE