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NPI Code Detail

MEDICARE: DR. JEREMY MCINTYRE PHARMD

MEDICARE: DR. JEREMY MCINTYRE PHARMD
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist12015NE

General Provider Information

NPI Number : 1265688063
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEREMY MCINTYRE PHARMD
Provider Business Mailing Address
First Line : 7250 SKY PARK RD
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68801-9117
Country : US
Telephone Number : 402-699-4778
Fax Number :
Provider Business Practice Location Address
First Line : 2201 N BROADWELL AVE
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-2153
Country : US
Telephone Number : 402-699-4778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2008
Last Update Date : 08/12/2008

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