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NPI Code Detail

MEDICARE: JENNIFER L WINSTEAD CPHT

MEDICARE: JENNIFER L WINSTEAD CPHT
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
1183700000XPharmacy Technician12901SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112901OTHERSCSC BOARD OF PHARMACY

General Provider Information

NPI Number : 1679726210
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER L WINSTEAD CPHT
Provider Business Mailing Address
First Line : 102 S ALABAMA AVE
Second Line :
City : CHESNEE
State : SC
Zip : 29323-1502
Country : US
Telephone Number : 864-461-2314
Fax Number : 864-461-5384
Provider Business Practice Location Address
First Line : 102 S ALABAMA AVE
Second Line :
City : CHESNEE
State : SC
Zip : 29323-1502
Country : US
Telephone Number : 864-461-2314
Fax Number : 864-461-5384
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2008
Last Update Date : 10/28/2008

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