Healthcare Provider Details

I. General information

NPI: 1215011432
Provider Name (Legal Business Name): JEFFERY MICHAEL WORLEY PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JEFFREY MICHAEL WORLEY PHARM.D.

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2071 HERNDON AVE
CLOVIS CA
93611-6101
US

IV. Provider business mailing address

7300 N FRESNO ST MEDICINE 2, CLOVIS
FRESNO CA
93720-2941
US

V. Phone/Fax

Practice location:
  • Phone: 559-324-5071
  • Fax: 559-324-5571
Mailing address:
  • Phone: 559-324-5071
  • Fax: 559-324-5571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 49263
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: