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General NPI Number Information
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NPI Number | 1831714989
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Entity Type | Individual
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Provider Name | JEREMY MICHAEL GERBER PHARMD, MBA
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Gender | Male
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 14200 W CELEBRATE LIFE WAY
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City | GOODYEAR
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State | AZ
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Zip | 85338-3007
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Country | US
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Telephone | 623-207-3247
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Fax |
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Provider Business Mailing Address
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Address Line | 13621 W VERDE LN
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City | AVONDALE
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State | AZ
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Zip | 85392-3564
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Country | US
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Telephone | 570-239-3987
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 15008
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | 15008
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 15008
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License Number State | AZ
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