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Contact Information

CORNELIA Y JACKSON
701 GROVE RD
GREENVILLE, SC29605-4210
 Phone: 864-455-8418
 Fax: 864-522-1731
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy Technician

183700000X
Indicates primary specialty

NPI Profile & details for CORNELIA Y JACKSON · (Female)

NPI # 1356280515
Status Active
Credentials
Entity Individual
Enumeration date 03/25/2026
Last updated 03/25/2026 - About 2 months ago
Sole proprietor 1 No
Identifiers
  • SC License # 17499
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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