Provider Demographics
NPI:1487680047
Name:MATHENEY-ARQUIT, JENIFER (RPH)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:MATHENEY-ARQUIT
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 1:836 PRUDENTIAL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8119
Mailing Address - Country:US
Mailing Address - Phone:904-202-5288
Mailing Address - Fax:904-346-0571
Practice Address - Street 1:836 PRUDENTIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8119
Practice Address - Country:US
Practice Address - Phone:904-202-5288
Practice Address - Fax:904-346-0571
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS19492183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist