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General NPI Number Information
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NPI Number | 1841897329
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Entity Type | Individual
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Provider Name | TAMYRA JAUREGUI
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Gender | Female
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 505 TOURING DR
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City | AUBURN
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State | IN
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Zip | 46706-2054
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Country | US
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Telephone | 260-925-8083
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Fax |
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Provider Business Mailing Address
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Address Line | 2270 COUNTY ROAD 28
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City | WATERLOO
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State | IN
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Zip | 46793
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Country | US
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Telephone | 260-437-0164
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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 | 26017959A
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License Number State | IN
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