Healthcare Provider Details

I. General information

NPI: 1770674772
Provider Name (Legal Business Name): DAVID RICHARD JARNOT PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 04/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 MDG BLDG 121 ROOM GC45
APO AE
09601
US

IV. Provider business mailing address

31 MDG BLDG 121 ROOM GC45
APO AE
09601
US

V. Phone/Fax

Practice location:
  • Phone: 509-247-3355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00067205
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-27448
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: