MEDICARE: STEPHANIE JARRETT PHARMD, 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
1	183500000X	Pharmacist	PS45355	FL
2	183500000X	Pharmacist	PHA.0023230	CO

General Provider Information

NPI Number	:	1386248698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE JARRETT PHARMD, RPH

Provider Business Mailing Address
First Line	:	5702 SHEPHERD ST
Second Line	:
City	:	TIMNATH
State	:	CO
Zip	:	80547-2284
Country	:	US
Telephone Number	:	850-628-1796
Fax Number	:

Provider Business Practice Location Address
First Line	:	2936 COUNCIL TREE AVE
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-6300
Country	:	US
Telephone Number	:	970-530-3121
Fax Number	:

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

Provider Enumeration Date	:	11/27/2020
Last Update Date	:	11/27/2020

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