Provider Demographics
NPI:1093291270
Name:MEYERS, JORDAN CHARLES (PHARMD)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:CHARLES
Last Name:MEYERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-4008
Mailing Address - Country:US
Mailing Address - Phone:803-276-6350
Mailing Address - Fax:803-276-4064
Practice Address - Street 1:1210 WILSON RD
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-4008
Practice Address - Country:US
Practice Address - Phone:803-276-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist