Provider Demographics
NPI:1346443629
Name:WILLIAMS, JENNIFER LYN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:LYN
Other - Last Name:EISENHOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4611 HARD SCRABBLE RD
Mailing Address - Street 2:PHARMACY
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8584
Mailing Address - Country:US
Mailing Address - Phone:803-736-9599
Mailing Address - Fax:
Practice Address - Street 1:4611 HARD SCRABBLE RD
Practice Address - Street 2:PHARMACY
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-8584
Practice Address - Country:US
Practice Address - Phone:803-736-9599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36274183500000X
SCPH13899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist