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General NPI Number Information
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NPI Number | 1134854102
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Entity Type | Individual
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Provider Name | JESSICA POKORA PHARM.D., BCGP
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Gender | Female
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 1830 W DIXON BLVD
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City | SHELBY
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State | NC
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Zip | 28152-4351
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Country | US
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Telephone | 704-482-0336
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Fax |
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Provider Business Mailing Address
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Address Line | 7062 DUNCAN ACRES DR
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City | BELMONT
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State | NC
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Zip | 28012-0130
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH236209
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS53955
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 9107099
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 31153
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License Number State | NC
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