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General NPI Number Information
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NPI Number | 1740993914
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Entity Type | Individual
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Provider Name | JENNA MARIE GIACOMIN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/03/2023
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Last Update Date | 01/28/2023
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Provider Practice Location Address
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Address Line | 1640 CRAWFORDSVILLE SQUARE DR
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-3800
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Country | US
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Telephone | 765-359-1113
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 S MAIN ST
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City | CROWN POINT
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State | IN
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Zip | 46307-8481
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Country | US
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Telephone | 219-476-6452
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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 | 26028810A
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License Number State | IN
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