Healthcare Provider Details

I. General information

NPI: 1346557147
Provider Name (Legal Business Name): JEFFRERY H WEINBERG RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 09/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 NORTH AVE
GRAND JUNCTION CO
81501-6428
US

IV. Provider business mailing address

256 WINDOW ROCK CT
GRAND JUNCTION CO
81507-1165
US

V. Phone/Fax

Practice location:
  • Phone: 970-263-2800
  • Fax: 970-256-8900
Mailing address:
  • Phone: 970-261-9308
  • Fax: 970-242-4848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16309
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: