Provider Demographics
NPI:1760926950
Name:GRIER, JENNIFER KELLY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KELLY
Last Name:GRIER
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 1:103 POPLAR ST
Mailing Address - Street 2:PO BOX 208
Mailing Address - City:HURLOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21643-3407
Mailing Address - Country:US
Mailing Address - Phone:410-943-4959
Mailing Address - Fax:410-943-3028
Practice Address - Street 1:103 POPLAR ST
Practice Address - Street 2:
Practice Address - City:HURLOCK
Practice Address - State:MD
Practice Address - Zip Code:21643-3407
Practice Address - Country:US
Practice Address - Phone:410-943-4959
Practice Address - Fax:410-943-3028
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist