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General NPI Number Information
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NPI Number | 1396819777
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Entity Type | Individual
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Provider Name | COLLEEN LEARY JOCHEM RPH PHARM D
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2160 SOUTH FEDERAL HIGHWAY WINN DIXIE PHARMACY STORE 307
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City | STUART
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State | FL
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Zip | 34994
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Country | US
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Telephone | 772-221-3402
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Fax | 772-221-3505
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Provider Business Mailing Address
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Address Line | 993 NE ORANGE AVE
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City | JENSEN BEACH
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State | FL
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Zip | 34957
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Country | US
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Telephone | 772-334-2777
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Fax | 772-334-8444
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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 | PS23178
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License Number State | FL
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