MEDICARE: CELINE JABRO PHARMACIST

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	24699	NV

General Provider Information

NPI Number	:	1437091626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELINE JABRO PHARMACIST

Provider Business Mailing Address
First Line	:	4760 E BASELINE RD APT 2050
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4689
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6480 SKY POINTE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4038
Country	:	US
Telephone Number	:	702-656-4791
Fax Number	:

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

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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