Provider Demographics
NPI:1285047662
Name:JEFFRIES, CALVERT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CALVERT
Middle Name:
Last Name:JEFFRIES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3917 WESTPOINT BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6723
Mailing Address - Country:US
Mailing Address - Phone:336-748-0556
Mailing Address - Fax:
Practice Address - Street 1:3917 WESTPOINT BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6723
Practice Address - Country:US
Practice Address - Phone:336-748-0556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist