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NPI Code Detail

MEDICARE: JEAN R GENDILL RPH

MEDICARE: JEAN R GENDILL 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
1183500000XPharmacist147766CO

General Provider Information

NPI Number : 1356777015
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN R GENDILL RPH
Provider Business Mailing Address
First Line : 5050 S FEDERAL BLVD
Second Line :
City : ENGLEWOOD
State : CO
Zip : 80110-6361
Country : US
Telephone Number : 303-794-6397
Fax Number :
Provider Business Practice Location Address
First Line : 5050 S FEDERAL BLVD
Second Line :
City : ENGLEWOOD
State : CO
Zip : 80110-6361
Country : US
Telephone Number : 303-794-6397
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2013
Last Update Date : 09/25/2013

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Directions to “ JEAN R GENDILL RPH” Practice Location

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