Provider Demographics
NPI:1962106922
Name:BARTHOLOMEW, JENNIFER M (CPHT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 TUSCARAWAS ST W
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-5619
Mailing Address - Country:US
Mailing Address - Phone:440-258-4116
Mailing Address - Fax:
Practice Address - Street 1:3720 TUSCARAWAS ST W
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-5619
Practice Address - Country:US
Practice Address - Phone:440-258-4116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30118163183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician