Provider Demographics
NPI:1083969653
Name:MCANINCH, JILL MARIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:MARIE
Last Name:MCANINCH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 TOWN CENTER DR
Mailing Address - Street 2:T-2294
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-9262
Mailing Address - Country:US
Mailing Address - Phone:540-941-2281
Mailing Address - Fax:
Practice Address - Street 1:811 TOWN CENTER DR
Practice Address - Street 2:T-2294
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-9262
Practice Address - Country:US
Practice Address - Phone:540-941-2281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist