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NPI Code Detail

MEDICARE: DR. JADE ONKLE PHARMD, RPH

MEDICARE: DR. JADE ONKLE PHARMD, 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
13336C0003XCommunity/Retail Pharmacy149289AK

General Provider Information

NPI Number : 1437762879
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JADE ONKLE PHARMD, RPH
Provider Business Mailing Address
First Line : 5411 MOCKINGBIRD DR APT 309
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-1690
Country : US
Telephone Number : 618-946-1938
Fax Number :
Provider Business Practice Location Address
First Line : 2550 E 88TH AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-3814
Country : US
Telephone Number : 907-349-9292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2020
Last Update Date : 08/25/2020

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