Healthcare Provider Details

I. General information

NPI: 1114196953
Provider Name (Legal Business Name): JENNIFER LIND SHAWVER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR EVANS ARMY COMMUNITY HOSPITAL PHARMACY
FT CARSON CO
80913-4603
US

IV. Provider business mailing address

1650 COCHRANE CIRCLE EVANS ARMY COMMUNITY HOSPITAL OUTPATIENT PHARMACY
FT CARSON CO
80913
US

V. Phone/Fax

Practice location:
  • Phone: 719-524-1062
  • Fax:
Mailing address:
  • Phone: 719-524-1062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4865
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: