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NPI Code Detail

MEDICARE: JENNIFER ANN CAK RPH

MEDICARE: JENNIFER ANN CAK 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
1183500000XPharmacist14917AL

General Provider Information

NPI Number : 1467721167
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER ANN CAK RPH
Provider Business Mailing Address
First Line : 31265 OAKRIDGE CT
Second Line :
City : SPANISH FORT
State : AL
Zip : 36527-3160
Country : US
Telephone Number : 251-626-0455
Fax Number :
Provider Business Practice Location Address
First Line : 30957 MILL LN
Second Line :
City : SPANISH FORT
State : AL
Zip : 36527-5453
Country : US
Telephone Number : 251-625-4668
Fax Number : 251-625-4774
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2011
Last Update Date : 12/26/2011

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