MEDICARE: ERIN K JENNINGS 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
1	183500000X	Pharmacist	PH60020701	WA

General Provider Information

NPI Number	:	1366602260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN K JENNINGS PHARMD

Provider Business Mailing Address
First Line	:	3804 S MORROW LN
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-7006
Country	:	US
Telephone Number	:	509-290-3005
Fax Number	:

Provider Business Practice Location Address
First Line	:	22820 E APPLEWAY AVE
Second Line	:
City	:	LIBERTY LAKE
State	:	WA
Zip	:	99019-9514
Country	:	US
Telephone Number	:	509-473-4900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2008
Last Update Date	:	04/28/2011

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