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NPI Code Detail

MEDICARE: JEREMY CLARKE PHARMD

MEDICARE: JEREMY CLARKE 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
1183500000XPharmacistS019967AZ

General Provider Information

NPI Number : 1134542483
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY CLARKE PHARMD
Provider Business Mailing Address
First Line : 6150 S 35TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85041-5004
Country : US
Telephone Number : 602-243-8517
Fax Number :
Provider Business Practice Location Address
First Line : 6150 S 35TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85041-5004
Country : US
Telephone Number : 602-243-8517
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2014
Last Update Date : 01/22/2014

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Directions to “ JEREMY CLARKE PHARMD” Practice Location

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