Provider Demographics
NPI:1912385899
Name:O'NEILL, JAMIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LEIGH
Other - Last Name:SPARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:4000 BLUE RIDGE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4650
Mailing Address - Country:US
Mailing Address - Phone:919-376-1135
Mailing Address - Fax:
Practice Address - Street 1:4000 BLUE RIDGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4650
Practice Address - Country:US
Practice Address - Phone:919-376-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist