Provider Demographics
NPI:1366045411
Name:JONES, MARY MARGARET B
Entity Type:Individual
Prefix:
First Name:MARY MARGARET
Middle Name:B
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 E ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-3423
Mailing Address - Country:US
Mailing Address - Phone:434-447-3117
Mailing Address - Fax:434-447-2352
Practice Address - Street 1:807 E ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-3423
Practice Address - Country:US
Practice Address - Phone:434-447-3117
Practice Address - Fax:434-447-2352
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist