Provider Demographics
NPI:1124326194
Name:MCPHAIL, JENNIFER O'NEAL
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:O'NEAL
Last Name:MCPHAIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 FARROW DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-7760
Mailing Address - Country:US
Mailing Address - Phone:803-366-1561
Mailing Address - Fax:
Practice Address - Street 1:1705 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1101
Practice Address - Country:US
Practice Address - Phone:803-366-3114
Practice Address - Fax:803-366-3605
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12597183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist