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NPI Code Detail

MEDICARE: DR. JACLYN JUNE EDWARDS RPH

MEDICARE: DR. JACLYN JUNE EDWARDS RPH
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
1183500000XPharmacist4267WY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14267OTHERWYBOARD OF PHARMACY

General Provider Information

NPI Number : 1184239378
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACLYN JUNE EDWARDS RPH
Provider Business Mailing Address
First Line : 70 GATEWAY BLVD
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-5709
Country : US
Telephone Number : 307-382-2536
Fax Number :
Provider Business Practice Location Address
First Line : 70 GATEWAY BLVD
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-5709
Country : US
Telephone Number : 307-382-2536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2020
Last Update Date : 12/19/2022

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