Jennifer R Green, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

10957 Issued in SC

Practice address

330 W Church St
Batesburg-Leesville, SC 29006-2002

Phone

(803) 532-0293

NPI assigned

Mar 3, 2007

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Freds Stores of Tennessee Inc

  • Community/Retail Pharmacy
  • Batesburg-Leesville, SC
  • NPI 1003848946
  NPD (past)
• Freds Stores of Tennessee Inc

  • Community/Retail Pharmacy
  • Greenville, MS
  • NPI 1093969016
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124157581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W CHURCH ST",
            "city": "BATESBURG-LEESVILLE",
            "state": "SC",
            "postal_code": "290062002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W CHURCH ST",
            "city": "BATESBURG-LEESVILLE",
            "state": "SC",
            "postal_code": "290062002",
            "telephone_number": "803-532-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "10957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael Disisto Sr., PT DPT
• Lindsay Feary, PTA
• First Physical Therapy LLC
• Freds Stores of Tennessee Inc
• Casey E Grandy, DC
• Cooper Gunter
• Charles Walden Hanna, DMD
• Brandon Hass, DC
• Samantha Ivey Hatfield, LMSW
• Carol A Heebner, M.D.

• All providers in Batesburg-Leesville, SC
• Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.