MEDICARE: DR. JEREMY RAMOS

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	PD15849	AR

General Provider Information

NPI Number	:	1386217891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEREMY RAMOS

Provider Business Mailing Address
First Line	:	2874 W REDSTONE DR
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72704-5139
Country	:	US
Telephone Number	:	903-276-4437
Fax Number	:

Provider Business Practice Location Address
First Line	:	2874 W REDSTONE DR
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72704-5139
Country	:	US
Telephone Number	:	903-276-4437
Fax Number	:

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

Provider Enumeration Date	:	07/22/2021
Last Update Date	:	07/22/2021

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