Provider Demographics
NPI:1548582653
Name:JENKINS, GARNETT BROWN
Entity Type:Individual
Prefix:MRS
First Name:GARNETT
Middle Name:BROWN
Last Name:JENKINS
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 1:3431 MATTHEWS MINT HILL RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4030
Mailing Address - Country:US
Mailing Address - Phone:704-844-8908
Mailing Address - Fax:704-844-8216
Practice Address - Street 1:3431 MATTHEWS MINT HILL RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4030
Practice Address - Country:US
Practice Address - Phone:704-844-8908
Practice Address - Fax:704-844-8216
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10881183500000X
GARPH021122183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist