Provider Demographics
NPI:1114266590
Name:JENKINS, MARY ABIGAIL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ABIGAIL
Last Name:JENKINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-7525
Mailing Address - Country:US
Mailing Address - Phone:336-275-7657
Mailing Address - Fax:
Practice Address - Street 1:3001 E MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-7525
Practice Address - Country:US
Practice Address - Phone:336-275-7657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist