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General NPI Number Information
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NPI Number | 1275208068
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Entity Type | Individual
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Provider Name | JACOB ANTHONY VALENTINE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 1865 HENDERSONVILLE RD
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City | ASHEVILLE
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State | NC
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Zip | 28803-3217
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Country | US
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Telephone | 828-274-1328
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Fax | 828-274-3431
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Provider Business Mailing Address
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Address Line | 6 ASCOT POINT CIR APT 308
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City | ASHEVILLE
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State | NC
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Zip | 28803-7723
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Country | US
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Telephone | 828-442-9777
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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 | 30778
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License Number State | NC
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