Healthcare Provider Details

I. General information

NPI: 1699602631
Provider Name (Legal Business Name): JASMINE EARLENE MANNING PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 SAWMILL TRCE
HAMPTON GA
30228-1301
US

IV. Provider business mailing address

426 SAWMILL TRCE
HAMPTON GA
30228-1301
US

V. Phone/Fax

Practice location:
  • Phone: 678-977-3558
  • Fax:
Mailing address:
  • Phone: 678-977-3558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH031365
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: