MEDICARE: JORDAN RAJEWSKI

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	24270	CO

General Provider Information

NPI Number	:	1578335956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN RAJEWSKI

Provider Business Mailing Address
First Line	:	400 N PARK AVE
Second Line	:
City	:	BRECKENRIDGE
State	:	CO
Zip	:	80424-8709
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N PARK AVE
Second Line	:
City	:	BRECKENRIDGE
State	:	CO
Zip	:	80424-8709
Country	:	US
Telephone Number	:	970-547-9343
Fax Number	:

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

Provider Enumeration Date	:	10/27/2023
Last Update Date	:	10/27/2023

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Directions to “ JORDAN RAJEWSKI ” Practice Location

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