Provider Demographics
NPI:1063760999
Name:CALDWELL, JENNY HELMS (RPH)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:HELMS
Last Name:CALDWELL
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:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:LAKE JUNALUSKA
Mailing Address - State:NC
Mailing Address - Zip Code:28745-0213
Mailing Address - Country:US
Mailing Address - Phone:336-482-8000
Mailing Address - Fax:800-218-8498
Practice Address - Street 1:231 IRONWOOD DR.
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721
Practice Address - Country:US
Practice Address - Phone:336-482-8000
Practice Address - Fax:800-218-8498
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13197183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist