Healthcare Provider Details

I. General information

NPI: 1013089234
Provider Name (Legal Business Name): SHAUNA RENEE JARDON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S HAVANA ST PHARMACY CALL CENTER
AURORA CO
80014-1618
US

IV. Provider business mailing address

9057 E MISSISSIPPI AVE 14-203
DENVER CO
80247-2078
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-4454
  • Fax:
Mailing address:
  • Phone: 303-502-4056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number55524
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: