Provider Demographics
NPI:1457359846
Name:SKERTICH, JANIE U
Entity Type:Individual
Prefix:MRS
First Name:JANIE
Middle Name:U
Last Name:SKERTICH
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 1:206 PEARCE DR
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-8443
Mailing Address - Country:US
Mailing Address - Phone:336-454-5637
Mailing Address - Fax:
Practice Address - Street 1:803C FRIENDLY CENTER RD
Practice Address - Street 2:GATE CITY PHARMACY
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2024
Practice Address - Country:US
Practice Address - Phone:336-292-6888
Practice Address - Fax:336-294-9329
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist