Provider Demographics
NPI:1275208068
Name:VALENTINE, JACOB ANTHONY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:ANTHONY
Last Name:VALENTINE
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 1:6 ASCOT POINT CIR APT 308
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-7723
Mailing Address - Country:US
Mailing Address - Phone:828-442-9777
Mailing Address - Fax:
Practice Address - Street 1:1865 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3217
Practice Address - Country:US
Practice Address - Phone:828-274-1328
Practice Address - Fax:828-274-3431
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist