Healthcare Provider Details

I. General information

NPI: 1669801320
Provider Name (Legal Business Name): JASON BARKEMEYER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 HOSPITAL LOOP
FAIRCHILD AFB WA
99011-8704
US

IV. Provider business mailing address

701 HOSPITAL LOOP
FAIRCHILD AFB WA
99011-8704
US

V. Phone/Fax

Practice location:
  • Phone: 509-247-3355
  • Fax: 509-247-2021
Mailing address:
  • Phone: 509-247-3355
  • Fax: 509-247-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007990
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: