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NPI Code Detail

MEDICARE: DR. JADORE DOUGLAS PHARMD

MEDICARE: DR. JADORE DOUGLAS 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
1183500000XPharmacist0202216968VA

General Provider Information

NPI Number : 1386245421
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JADORE DOUGLAS PHARMD
Provider Business Mailing Address
First Line : 1301 RADIUS WAY
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-9084
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2601 GEORGE WASHINGTON MEM HWY
Second Line :
City : YORKTOWN
State : VA
Zip : 23693-3409
Country : US
Telephone Number : 757-867-8281
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2020
Last Update Date : 11/05/2020

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