Provider Demographics
NPI:1972743367
Name:MOLOFSKY, JILL R (BS)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:R
Last Name:MOLOFSKY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BIRCH BARK CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1319
Mailing Address - Country:US
Mailing Address - Phone:410-409-7706
Mailing Address - Fax:
Practice Address - Street 1:803 BARKWOOD CT STE A
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-1426
Practice Address - Country:US
Practice Address - Phone:410-636-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist