Provider Demographics
NPI:1518797232
Name:WILLIAMS, JESSICA H (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:H
Last Name:WILLIAMS
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 1:19 W CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENA ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29920-3626
Mailing Address - Country:US
Mailing Address - Phone:910-916-1225
Mailing Address - Fax:
Practice Address - Street 1:1500 RIBAUT RD
Practice Address - Street 2:
Practice Address - City:PORT ROYAL
Practice Address - State:SC
Practice Address - Zip Code:29935-1403
Practice Address - Country:US
Practice Address - Phone:700-600-0326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC60269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist