Jessica D Booth
Pharmacy, Community/Retail Pharmacy in Bridgeport, WV. Individual provider (NPI-1).
NPI number1679110290
StatusActive
Last updated in NPPESDec 2, 2019
Details
- NPI
- 1679110290
- Entity type
- Individual (NPI-1)
- Name
- Jessica D Booth
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 2, 2019
- Last updated
- Dec 2, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | RP0011851 | WV | Yes |
Practice location
300 W Main StBridgeport, WV 26330-1751
Phone 304-842-3131
Mailing address
4110 Kaustin DrMorgantown, WV 26501-7229
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All 13 Community/Retail Pharmacy providers in Bridgeport · All 1,140 providers in Bridgeport
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