Provider Demographics
NPI:1336367374
Name:JONES, REBECCA GRIFFIN
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:GRIFFIN
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 1:121 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-3601
Mailing Address - Country:US
Mailing Address - Phone:434-799-4247
Mailing Address - Fax:
Practice Address - Street 1:515 MOUNT CROSS RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4065
Practice Address - Country:US
Practice Address - Phone:434-799-6813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202006390183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist