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NPI Code Detail

MEDICARE: JESSICA KENT PHARM D.

MEDICARE: JESSICA KENT PHARM D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist2008027490MO

General Provider Information

NPI Number : 1891051421
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA KENT PHARM D.
Provider Business Mailing Address
First Line : 12293 SAINT CHARLES ROCK RD
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12293 SAINT CHARLES ROCK RD
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2502
Country : US
Telephone Number : 314-209-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2012
Last Update Date : 04/09/2012

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Directions to “ JESSICA KENT PHARM D.” Practice Location

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