Provider Demographics
NPI:1801280599
Name:MULLINNIX, JEREMY KEVIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:KEVIN
Last Name:MULLINNIX
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 1:200 SPARTANBURG HWY
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29365-1808
Mailing Address - Country:US
Mailing Address - Phone:864-949-0800
Mailing Address - Fax:864-949-0803
Practice Address - Street 1:200 SPARTANBURG HWY
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365-1808
Practice Address - Country:US
Practice Address - Phone:864-949-0800
Practice Address - Fax:864-949-0803
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist