Provider Demographics
NPI:1225454721
Name:JARAMILLO, JASON SCOTT (PHARM D)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:SCOTT
Last Name:JARAMILLO
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 BALLOON FIESTA PKWY NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113
Mailing Address - Country:US
Mailing Address - Phone:505-816-4000
Mailing Address - Fax:575-769-2495
Practice Address - Street 1:5701 BALLOON FIESTA PKWY NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113
Practice Address - Country:US
Practice Address - Phone:505-816-4000
Practice Address - Fax:575-769-2495
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist