Provider Demographics
NPI:1750901112
Name:JENKINS, RACHEL MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:JENKINS
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 1:12008 OLD WILLOW BROOK RD SE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-8340
Mailing Address - Country:US
Mailing Address - Phone:301-707-3525
Mailing Address - Fax:
Practice Address - Street 1:3 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1058
Practice Address - Country:US
Practice Address - Phone:301-777-1773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-25
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0010375183500000X
MD25439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist