Provider Demographics
NPI:1902057060
Name:MCGUIRE, JENNIFER MORTON (RPH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MORTON
Last Name:MCGUIRE
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 1:8292 CHATHAM OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-9606
Mailing Address - Country:US
Mailing Address - Phone:704-794-6233
Mailing Address - Fax:
Practice Address - Street 1:135 DALE EARNHARDT BLVD
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-0301
Practice Address - Country:US
Practice Address - Phone:704-938-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14243183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist