Healthcare Provider Details

I. General information

NPI: 1669225009
Provider Name (Legal Business Name): JESSICA BLAINE BRUMFIELD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 LEXINGTON AVE
ASHLAND KY
41101-2843
US

IV. Provider business mailing address

PO BOX 4105
CHARLESTON WV
25364-4105
US

V. Phone/Fax

Practice location:
  • Phone: 606-408-1187
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number018100
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number03234214
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberRP451371
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberRP0008815
License Number StateWV
# 5
Primary TaxonomyN
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License Number03234214
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License NumberRP451371
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License Number018100
License Number StateKY
# 8
Primary TaxonomyN
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License NumberRP0008815
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: