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NPI Code Detail

MEDICARE: DR. JORDAN JAMES PHARM D.

MEDICARE: DR. JORDAN JAMES 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
1183500000XPharmacist61501TX
2183500000XPharmacist2018014091MO

General Provider Information

NPI Number : 1598365587
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORDAN JAMES PHARM D.
Provider Business Mailing Address
First Line : 7605 RAVENSRIDGE RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63119-5503
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3527 CHOUTEAU AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63103-2915
Country : US
Telephone Number : 972-966-1980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2020
Last Update Date : 12/19/2022

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Directions to “ DR. JORDAN JAMES PHARM D.” Practice Location

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