Provider Demographics
NPI:1053749804
Name:WOLF, JENNIFER (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WOLF
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 HAMILTON CT
Mailing Address - Street 2:
Mailing Address - City:BADEN
Mailing Address - State:PA
Mailing Address - Zip Code:15005-9631
Mailing Address - Country:US
Mailing Address - Phone:724-876-0285
Mailing Address - Fax:
Practice Address - Street 1:500 NOBLESTOWN RD
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-1230
Practice Address - Country:US
Practice Address - Phone:412-353-4247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist