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General NPI Number Information
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NPI Number | 1801650148
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Entity Type | Individual
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Provider Name | JONATHAN JONES RPH
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Gender | Male
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 2701 W BURLINGTON AVE
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City | FAIRFIELD
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State | IA
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Zip | 52556-2645
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Country | US
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Telephone | 641-472-6199
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Fax |
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Provider Business Mailing Address
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Address Line | 10078 HILL BLVD
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City | DRAKESVILLE
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State | IA
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Zip | 52552-8624
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Country | US
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Telephone | 618-435-7572
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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 | 22393
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License Number State | IA
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