NPI 1023396835

Jeffrey Allen Medernach, RPH

Practitioner Pharmacist Peoria, IL

Practice location

Address: 2305 W Altorfer Dr, Peoria, IL 61615-1809
Phone: (309) 691-2010
Fax: (309) 693-5521

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 051034915 (IL)

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Registry record

NPI: 1023396835
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jul 2011
Record last updated: 27 Jul 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.