Tiffany Jacobs, PHARMD
Individual provider Active NPI Pharmacist · Eastern, KY
NPI 1962095646 · NPPES record last updated Feb 14, 2021
Key facts
- NPI
- 1962095646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 017215 (KY)
- Practice address
- 327 Ky Route 550
Eastern, KY 41622-6925 - Phone
- (606) 358-4800
- NPI assigned
- Feb 14, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017215 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Howard Family Pharmacy, Inc. | Past |
Accepting new patients | |
| Howard Family Pharmacy Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 017215 | KY | Yes |
Addresses
Primary practice location
327 Ky Route 550
Eastern, KY 41622-6925
Mailing address
PO Box 2
Garrett, KY 41630-0002
Phone (606) 226-3641
Other providers in Eastern, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2021. 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.