Provider Demographics
NPI:1740638659
Name:TORRES, JESSICA ERIN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ERIN
Last Name:TORRES
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 1:501 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:ELEANOR
Mailing Address - State:WV
Mailing Address - Zip Code:25070
Mailing Address - Country:US
Mailing Address - Phone:304-586-0886
Mailing Address - Fax:304-586-1057
Practice Address - Street 1:501 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:ELEANOR
Practice Address - State:WV
Practice Address - Zip Code:25070
Practice Address - Country:US
Practice Address - Phone:304-586-0886
Practice Address - Fax:304-586-1057
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008222183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist