Provider Demographics
NPI:1689864654
Name:WITCHER, JONES L (RPH)
Entity Type:Individual
Prefix:
First Name:JONES
Middle Name:L
Last Name:WITCHER
Suffix:
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 1:25 MEDICAL DR
Mailing Address - Street 2:REMEDIES PHARMACY
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4169
Mailing Address - Country:US
Mailing Address - Phone:806-242-9400
Mailing Address - Fax:806-242-9403
Practice Address - Street 1:25 MEDICAL DR
Practice Address - Street 2:REMEDIES PHARMACY
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4169
Practice Address - Country:US
Practice Address - Phone:806-242-9400
Practice Address - Fax:806-242-9403
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist