Jackson, Marcelina

Jackson, Marcelina is an sole proprietor health care provider with primary practice located at 2000 Hampton St , Columbia SC 29204-1002. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Jackson, Marcelina can be contacted via phone (803) 576-2900.

Contact Information

Primary practice address
2000 Hampton St Columbia SC 29204-1002
Phone: (803) 576-2900
Fax: (803) 576-2985
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 982 South Carolina

Profile Details

NPI number 1922414291
LBN Legal business name Jackson, Marcelina
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 8th, 2014
Last updated Jul 8th, 2014 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922414291 NPPES
South Carolina MEDICAID 576000286

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