Provider Demographics
NPI:1346532553
Name:GREENBERG, JODI LYNN (RPH)
Entity Type:Individual
Prefix:MS
First Name:JODI
Middle Name:LYNN
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9158
Mailing Address - Country:US
Mailing Address - Phone:704-799-1101
Mailing Address - Fax:
Practice Address - Street 1:134 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9158
Practice Address - Country:US
Practice Address - Phone:704-799-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20618183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist