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General NPI Number Information
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NPI Number | 1316490618
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Entity Type | Individual
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Provider Name | JESSIE ANH BOSEKE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 08/03/2016
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Provider Practice Location Address
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Address Line | 271 MAMMOTH RD
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City | MANCHESTER
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State | NH
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Zip | 03109-4124
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Country | US
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Telephone | 603-781-4865
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Fax |
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Provider Business Mailing Address
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Address Line | 92 GLENWOOD AVE
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City | DOVER
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State | NH
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Zip | 03820-2307
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Country | US
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Telephone | 603-781-4865
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4230
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License Number State | NH
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