Provider Demographics
NPI:1366611147
Name:KERRIGAN, JOSEPH FRANCIS JR
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:KERRIGAN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1568 CHESTER PIKE
Mailing Address - Street 2:SHOPRITE OF EDDYSTONE
Mailing Address - City:EDDYSTONE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1338
Mailing Address - Country:US
Mailing Address - Phone:610-471-0360
Mailing Address - Fax:610-471-0362
Practice Address - Street 1:1568 CHESTER PIKE
Practice Address - Street 2:SHOPRITE OF EDDYSTONE
Practice Address - City:EDDYSTONE
Practice Address - State:PA
Practice Address - Zip Code:19022-1338
Practice Address - Country:US
Practice Address - Phone:610-471-0360
Practice Address - Fax:610-471-0362
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2016-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP029020L183500000X
PARPI006016183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist