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General NPI Number Information
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NPI Number | 1629658299
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Entity Type | Individual
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Provider Name | AUTUMN R JONES CPHT
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Gender | Female
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 190 CHESTNUT ST
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City | COSHOCTON
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State | OH
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Zip | 43812-1129
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Country | US
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Telephone | 740-295-5403
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Fax |
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Provider Business Mailing Address
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Address Line | 122 FAIRVIEW ST
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City | WEST LAFAYETTE
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State | OH
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Zip | 43845-1003
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Country | US
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Telephone | 330-937-3400
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State |
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