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NPI Code Detail

MEDICARE: DR. JARED WAYNE ROSWURM PHARM.D.

MEDICARE:  DR. JARED WAYNE ROSWURM  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
1183500000XPharmacist15500AZ

General Provider Information

NPI Number : 1730480807
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JARED WAYNE ROSWURM PHARM.D.
Provider Business Mailing Address
First Line : 4005 E CHANDLER BLVD
Second Line :
City : PHOENIX
State : AZ
Zip : 85048-8888
Country : US
Telephone Number : 480-759-4479
Fax Number : 480-759-8644
Provider Business Practice Location Address
First Line : 4005 E CHANDLER BLVD
Second Line :
City : PHOENIX
State : AZ
Zip : 85048-8888
Country : US
Telephone Number : 480-759-4479
Fax Number : 480-759-8644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2010
Last Update Date : 11/05/2010

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Directions to “ DR. JARED WAYNE ROSWURM PHARM.D.” Practice Location

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