Healthcare Provider Details

I. General information

NPI: 1881676252
Provider Name (Legal Business Name): JOSEPH ALAN JEFFRIES R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

639 W MAIN ST
BARNESVILLE OH
43713-1039
US

IV. Provider business mailing address

69755 CRESTVIEW LN
SAINT CLAIRSVILLE OH
43950-8313
US

V. Phone/Fax

Practice location:
  • Phone: 740-425-5108
  • Fax: 740-425-5131
Mailing address:
  • Phone: 740-695-5972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03217976
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: