Provider Demographics
NPI:1942341904
Name:JENKINSON, GREG JOSEPH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:JOSEPH
Last Name:JENKINSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CHESANING
Mailing Address - State:MI
Mailing Address - Zip Code:48616-1068
Mailing Address - Country:US
Mailing Address - Phone:989-845-9355
Mailing Address - Fax:
Practice Address - Street 1:1115 W BROAD ST
Practice Address - Street 2:
Practice Address - City:CHESANING
Practice Address - State:MI
Practice Address - Zip Code:48616-1068
Practice Address - Country:US
Practice Address - Phone:989-845-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302029207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist