Healthcare Provider Details

I. General information

NPI: 1982699401
Provider Name (Legal Business Name): JENNIFER LYNN DOPAO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 03/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 ACUSHNET AVE
NEW BEDFORD MA
02745-2803
US

IV. Provider business mailing address

2206 ACUSHNET AVE
NEW BEDFORD MA
02745-2803
US

V. Phone/Fax

Practice location:
  • Phone: 508-998-1121
  • Fax: 508-998-1122
Mailing address:
  • Phone: 508-998-1121
  • Fax: 508-998-1122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24156
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: