Provider Demographics
NPI:1831792274
Name:JENKINS, RUTHELLA SNIDER (RPH)
Entity type:Individual
Prefix:MRS
First Name:RUTHELLA
Middle Name:SNIDER
Last Name:JENKINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MICHAELS PHARMACY
Mailing Address - Street 2:101 CHARWOOD DR
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210
Mailing Address - Country:US
Mailing Address - Phone:276-676-2900
Mailing Address - Fax:276-676-2915
Practice Address - Street 1:MICHAELS PHARMACY
Practice Address - Street 2:101 CHARWOOD DR
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210
Practice Address - Country:US
Practice Address - Phone:276-676-2900
Practice Address - Fax:276-676-2915
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010451183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist