Provider Demographics
NPI:1396394821
Name:STRICKLAND, JONATHAN DESMOND (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DESMOND
Last Name:STRICKLAND
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 1:130 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:VARNVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29944-4856
Mailing Address - Country:US
Mailing Address - Phone:803-942-2411
Mailing Address - Fax:
Practice Address - Street 1:968 RIBAUT RD STE 1
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-8003
Practice Address - Country:US
Practice Address - Phone:843-379-3278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-07
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist