Provider Demographics
NPI:1417262635
Name:MAY, JENNIFER MARY (RPH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARY
Last Name:MAY
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 1:6 ECKERT RD
Mailing Address - Street 2:
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-4821
Mailing Address - Country:US
Mailing Address - Phone:609-458-3389
Mailing Address - Fax:
Practice Address - Street 1:1636 ROUTE 38
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-2900
Practice Address - Country:US
Practice Address - Phone:609-261-1330
Practice Address - Fax:609-261-7253
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02762500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist