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General NPI Number Information
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NPI Number | 1497234991
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Entity Type | Individual
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Provider Name | JESSICA ANNE PRESTIA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/07/2018
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 127 W COLUMBIA AVE
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City | BATESBURG
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State | SC
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Zip | 29006-2124
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Country | US
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Telephone | 803-532-2586
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Fax | 803-532-6644
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Provider Business Mailing Address
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Address Line | 117 PORT O CALL PL
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City | LEESVILLE
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State | SC
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Zip | 29070-7027
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Country | US
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Telephone | 864-999-0291
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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 | RPH031262
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License Number State | GA
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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 | 37850
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License Number State | SC
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