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General NPI Number Information
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NPI Number | 1528071750
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Entity Type | Individual
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Provider Name | JENNIFER ALICE RETTERER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 650 E INDIAN SCHOOL RD CLINICAL PHARMACY DEPT - 119A
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City | PHOENIX
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State | AZ
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Zip | 85012-1839
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Country | US
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Telephone | 602-277-5551
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Fax |
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Provider Business Mailing Address
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Address Line | 16407 N 2ND AVE
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City | PHOENIX
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State | AZ
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Zip | 85023-7513
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Country | US
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Telephone | 602-881-4702
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 11597
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License Number State | AZ
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