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NPI Code Detail

MEDICARE: WENDY JACOBS

MEDICARE: WENDY JACOBS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist10895MD

General Provider Information

NPI Number : 1205135647
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY JACOBS
Provider Business Mailing Address
First Line : 144 DEPOT RD
Second Line :
City : FROSTBURG
State : MD
Zip : 21532-1312
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 BISHOP MURPHY DR
Second Line :
City : FROSTBURG
State : MD
Zip : 21532-1329
Country : US
Telephone Number : 301-689-2422
Fax Number : 301-689-2919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2011
Last Update Date : 03/24/2011

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Directions to “ WENDY JACOBS ” Practice Location

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