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NPI Code Detail

MEDICARE: JORDAN K BOLOOKI PHARMD

MEDICARE: JORDAN K BOLOOKI 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
1183500000XPharmacistPS47861FL

General Provider Information

NPI Number : 1336065549
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN K BOLOOKI PHARMD
Provider Business Mailing Address
First Line : 3700 COLONNADE PKWY STE 600
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35243-3219
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3700 COLONNADE PKWY STE 600
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35243-3219
Country : US
Telephone Number : 800-377-1614
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2026
Last Update Date : 06/24/2026

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Directions to “ JORDAN K BOLOOKI PHARMD” Practice Location

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