Provider Demographics
NPI:1023147162
Name:AVOLIO, JOHN J (RPH,CGP)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:AVOLIO
Suffix:
Gender:M
Credentials:RPH,CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-2906
Mailing Address - Country:US
Mailing Address - Phone:724-940-2847
Mailing Address - Fax:
Practice Address - Street 1:459 S 7TH ST
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-2906
Practice Address - Country:US
Practice Address - Phone:724-940-2847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032220L1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric