Provider Demographics
NPI:1386938140
Name:KALDEN, JEANE (PHARMACIST)
Entity type:Individual
Prefix:
First Name:JEANE
Middle Name:
Last Name:KALDEN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3519 CLEMSON BOULEVARD
Mailing Address - Street 2:T-1198
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621
Mailing Address - Country:US
Mailing Address - Phone:864-224-3972
Mailing Address - Fax:
Practice Address - Street 1:3519 CLEMSON BOULEVARD
Practice Address - Street 2:T-1198
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-224-3972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11722183500000X
IL051038130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist