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NPI Code Detail

MEDICARE: JENNIFER MARIE MIRANDA PHARM D.

MEDICARE: JENNIFER MARIE MIRANDA PHARM D.
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
1183500000XPharmacist4569MT

General Provider Information

NPI Number : 1588655088
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MARIE MIRANDA PHARM D.
Provider Business Mailing Address
First Line : 14 REDWOOD DR
Second Line :
City : BUTTE
State : MT
Zip : 59701-4340
Country : US
Telephone Number : 406-496-6029
Fax Number : 406-723-3059
Provider Business Practice Location Address
First Line : 445 CENTENNIAL AVE
Second Line :
City : BUTTE
State : MT
Zip : 59701-2870
Country : US
Telephone Number : 406-496-6029
Fax Number : 406-723-3059
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 04/24/2020

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Directions to “ JENNIFER MARIE MIRANDA PHARM D.” Practice Location

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