Provider Demographics
NPI:1255947925
Name:MARCANTEL, JASMINE O (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:O
Last Name:MARCANTEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4717 HWY 80 E
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2943
Mailing Address - Country:US
Mailing Address - Phone:912-898-2337
Mailing Address - Fax:
Practice Address - Street 1:4717 HWY 80 E STE B
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-2944
Practice Address - Country:US
Practice Address - Phone:912-898-2337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42721183500000X
GARPH032375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist