Provider Demographics
NPI:1952739583
Name:MAYO, JEFFREY C (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:C
Last Name:MAYO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CLAY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67432-2936
Mailing Address - Country:US
Mailing Address - Phone:785-632-3121
Mailing Address - Fax:785-632-2440
Practice Address - Street 1:713 5TH ST
Practice Address - Street 2:
Practice Address - City:CLAY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67432-2936
Practice Address - Country:US
Practice Address - Phone:785-632-3121
Practice Address - Fax:785-632-2440
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-11226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist