Provider Demographics
NPI:1023309275
Name:JONES, LYNDA BRIDICKAS (RPH)
Entity type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:BRIDICKAS
Last Name:JONES
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 1:2104 DARIEN PL NW
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-1582
Mailing Address - Country:US
Mailing Address - Phone:252-237-0834
Mailing Address - Fax:
Practice Address - Street 1:1326 WARD BLVD
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4665
Practice Address - Country:US
Practice Address - Phone:252-237-5127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist