Provider Demographics
NPI:1710247317
Name:JEFFRIES, BETH ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43713-1004
Mailing Address - Country:US
Mailing Address - Phone:740-425-1582
Mailing Address - Fax:740-425-1795
Practice Address - Street 1:148 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43713-1004
Practice Address - Country:US
Practice Address - Phone:740-425-1582
Practice Address - Fax:740-425-1795
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03221607183500000X
WV5703183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist