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General NPI Number Information
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NPI Number | 1326356767
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Entity Type | Individual
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Provider Name | ROBERT EUGENE JENNINGS JR. PHARM,D
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Gender | Male
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Dates
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Enumeration Date | 09/20/2010
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Last Update Date | 11/08/2016
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Provider Practice Location Address
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Address Line | 510 OLD MADISON RD
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City | QUITMAN
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State | GA
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Zip | 31643
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Country | US
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Telephone | 229-465-9869
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5014
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City | QUITMAN
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State | GA
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Zip | 31643-5014
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Country | US
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Telephone | 229-522-8969
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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 | PS24014
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License Number State | FL
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