Booth, Jessica D
Booth, Jessica D is an sole proprietor health care provider with primary practice located at 300 W Main St , Bridgeport WV 26330-1751. She recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as her primary health care specialty. Booth, Jessica D can be contacted via phone (304) 842-3131.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | RP0011851 | West Virginia |
Profile Details
| NPI number | 1679110290 |
|---|---|
| LBN Legal business name | Booth, Jessica D |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 2nd, 2019 |
| Last updated | Dec 2nd, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679110290 | NPPES |
| West Virginia | Other | RP0011851 | PHARMACIST LICENSE |
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