Jacquelyn Lee Briscoe, PHARM D
Individual provider Active NPI Pharmacist · Fort Recovery, OH
NPI 1639235146 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1639235146
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03-2-26302 (OH)
- Practice address
- 110 East Butler St
Fort Recovery, OH 45846-0605 - Phone
- (419) 375-2323
- Fax
- (419) 375-4488
- NPI assigned
- Dec 29, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jlkgt Investments LLC | Current | Accepting new patients | |
| Kaup Pharmacy, Inc. | Past | Accepting new patients | |
| Kaup Pharmacy Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03-2-26302 | OH | Yes |
Addresses
Primary practice location
110 East Butler St
Fort Recovery, OH 45846-0605
Mailing address
9365 W Klinger Rd
Covington, OH 45318-9643
Phone (937) 473-3031
Other providers in Fort Recovery, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.