Provider Demographics
NPI:1275126278
Name:LEGGE, JESSICA THIGPEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:THIGPEN
Last Name:LEGGE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:MARIE
Other - Last Name:THIGPEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 S MORGAN AVE
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:SC
Mailing Address - Zip Code:29510-2694
Mailing Address - Country:US
Mailing Address - Phone:843-264-5454
Mailing Address - Fax:843-264-8362
Practice Address - Street 1:7 S MORGAN AVE
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:SC
Practice Address - Zip Code:29510-2694
Practice Address - Country:US
Practice Address - Phone:843-264-5454
Practice Address - Fax:843-264-8362
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist