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NPI Code Detail

MEDICARE: JARED STOCKWELL PHARMD

MEDICARE: JARED STOCKWELL PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH-0014192OR

General Provider Information

NPI Number : 1104772961
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARED STOCKWELL PHARMD
Provider Business Mailing Address
First Line : 2237 ALOHA AVE
Second Line :
City : MEDFORD
State : OR
Zip : 97504-6937
Country : US
Telephone Number : 530-591-3057
Fax Number :
Provider Business Practice Location Address
First Line : 1111 CRATER LAKE AVE
Second Line :
City : MEDFORD
State : OR
Zip : 97504-6241
Country : US
Telephone Number : 541-732-5541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2026
Last Update Date : 03/05/2026

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Directions to “ JARED STOCKWELL PHARMD” Practice Location

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