Provider Demographics
NPI:1992037238
Name:JONES, CYNTHIA ANN
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 FRIEND ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-3453
Mailing Address - Country:US
Mailing Address - Phone:803-276-8421
Mailing Address - Fax:
Practice Address - Street 1:4400 FORT JACKSON BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1006
Practice Address - Country:US
Practice Address - Phone:803-782-8508
Practice Address - Fax:803-738-1889
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist