Provider Demographics
NPI:1861710873
Name:TUMOLO, EILEEN MARIE (RPH,CIP)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:MARIE
Last Name:TUMOLO
Suffix:
Gender:F
Credentials:RPH,CIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1307
Mailing Address - Country:US
Mailing Address - Phone:610-358-3701
Mailing Address - Fax:
Practice Address - Street 1:3120 CHICHESTER AVE
Practice Address - Street 2:RITE AID 11112
Practice Address - City:UPPER CHICHESTER
Practice Address - State:PA
Practice Address - Zip Code:19061-3251
Practice Address - Country:US
Practice Address - Phone:610-494-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036019L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist