Provider Demographics
NPI:1649872375
Name:JENKINS, JOSH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSH
Middle Name:
Last Name:JENKINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 IRVIN COBB DRIVE
Mailing Address - Street 2:PHARMACY
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003
Mailing Address - Country:US
Mailing Address - Phone:270-442-6404
Mailing Address - Fax:270-442-0743
Practice Address - Street 1:3220 IRVIN COBB DRIVE
Practice Address - Street 2:WALMART PHARMACY
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003
Practice Address - Country:US
Practice Address - Phone:270-442-6404
Practice Address - Fax:270-442-0743
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019968183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist