Provider Demographics
NPI:1891906004
Name:BAIR, JENNIFER D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:D
Last Name:BAIR
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 1:292 SANDSTONE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-8261
Mailing Address - Country:US
Mailing Address - Phone:803-781-9856
Mailing Address - Fax:
Practice Address - Street 1:5 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6863
Practice Address - Country:US
Practice Address - Phone:803-434-3769
Practice Address - Fax:803-434-2526
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9692183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist