Provider Demographics
NPI:1841508934
Name:JADALLAH, JENNIFER BETH BAILEY (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BETH BAILEY
Last Name:JADALLAH
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 1:1233 PROVIDENCE KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236-2174
Mailing Address - Country:US
Mailing Address - Phone:804-928-6056
Mailing Address - Fax:
Practice Address - Street 1:4816 S LABURNUM AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-2714
Practice Address - Country:US
Practice Address - Phone:804-226-0010
Practice Address - Fax:804-222-3755
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202209326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist