MEDICARE: JESSICA MICHELLE GREENE PHARMD

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
1	183500000X	Pharmacist	24233	NC

General Provider Information

NPI Number	:	1285049338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MICHELLE GREENE PHARMD

Provider Business Mailing Address
First Line	:	329 BEARD HALL
Second Line	:	CB #7355
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599
Country	:	US
Telephone Number	:	919-445-0150
Fax Number	:

Provider Business Practice Location Address
First Line	:	2606 CAROLINA BEACH RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-1806
Country	:	US
Telephone Number	:	910-799-5548
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2014
Last Update Date	:	06/24/2015

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