Provider Demographics
NPI:1619499035
Name:HUDSPETH, JERRY WEBB II (RPH)
Entity Type:Individual
Prefix:MR
First Name:JERRY
Middle Name:WEBB
Last Name:HUDSPETH
Suffix:II
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 MARNIE LN
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-7665
Mailing Address - Country:US
Mailing Address - Phone:864-915-2145
Mailing Address - Fax:
Practice Address - Street 1:221 MARNIE LN
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651
Practice Address - Country:US
Practice Address - Phone:864-299-3469
Practice Address - Fax:864-277-3396
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist