Provider Demographics
NPI:1851996227
Name:NEWCOMB, JEANNE K (RPH)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:K
Last Name:NEWCOMB
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 1:5559 BARNESVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:VA
Mailing Address - Zip Code:23964-5117
Mailing Address - Country:US
Mailing Address - Phone:434-579-4052
Mailing Address - Fax:
Practice Address - Street 1:1013 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23927-9040
Practice Address - Country:US
Practice Address - Phone:434-374-5620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202009099183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist