Provider Demographics
NPI:1205473238
Name:ANDERSON, JAMIE LEIGH (PHARM D)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEIGH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 HIGHWAY 45 N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-2152
Mailing Address - Country:US
Mailing Address - Phone:662-327-9562
Mailing Address - Fax:662-327-9563
Practice Address - Street 1:1829 HIGHWAY 45 N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2152
Practice Address - Country:US
Practice Address - Phone:662-327-9562
Practice Address - Fax:662-327-9563
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-10
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-098211835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist