Individual
PAULA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7595 GREENBELT RD, SAFEWAY PHARMACY, GREENBELT, MD 20770-3403
(301) 345-8777
(301) 220-1217
Mailing address
7595 GREENBELT RD, SAFEWAY PHARMACY, GREENBELT, MD 20770-3403
(301) 345-8777
(301) 220-1217
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12635
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12635
RPH LICENSE
MD
Enumeration date
11/26/2010
Last updated
11/26/2010
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