Healthcare Provider Details

I. General information

NPI: 1720743578
Provider Name (Legal Business Name): JESSE JAMES ALARCON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2021
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 IOWA ST
LAWRENCE KS
66046-2508
US

IV. Provider business mailing address

326 DEAN CT
LAWRENCE KS
66049-4910
US

V. Phone/Fax

Practice location:
  • Phone: 785-841-5110
  • Fax: 785-832-6833
Mailing address:
  • Phone: 316-518-6792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number1-103656
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: