MEDICARE: DOUGLAS B JONES RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	7995	CT

General Provider Information

NPI Number	:	1043746431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS B JONES RPH

Provider Business Mailing Address
First Line	:	120 SALMON BROOK ST
Second Line	:
City	:	GRANBY
State	:	CT
Zip	:	06035-2604
Country	:	US
Telephone Number	:	860-844-8346
Fax Number	:	860-653-3210

Provider Business Practice Location Address
First Line	:	120 SALMON BROOK ST
Second Line	:
City	:	GRANBY
State	:	CT
Zip	:	06035-2604
Country	:	US
Telephone Number	:	860-844-8346
Fax Number	:	860-653-3210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2017
Last Update Date	:	05/04/2017

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Directions to “ DOUGLAS B JONES RPH” Practice Location

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