MEDICARE: JORDAN ARMELI PHARMD

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	I065568	NY

General Provider Information

NPI Number	:	1801432190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN ARMELI PHARMD

Provider Business Mailing Address
First Line	:	3081 ROUTE 22 STE 3
Second Line	:
City	:	DOVER PLAINS
State	:	NY
Zip	:	12522-5933
Country	:	US
Telephone Number	:	716-640-0986
Fax Number	:

Provider Business Practice Location Address
First Line	:	3081 ROUTE 22 STE 3
Second Line	:
City	:	DOVER PLAINS
State	:	NY
Zip	:	12522-5933
Country	:	US
Telephone Number	:	716-640-0986
Fax Number	:

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

Provider Enumeration Date	:	11/21/2019
Last Update Date	:	11/21/2019

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