Provider Demographics
NPI:1295005890
Name:AMIN, JAHNAVI PARTH (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAHNAVI
Middle Name:PARTH
Last Name:AMIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 MELROSE AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-1755
Mailing Address - Country:US
Mailing Address - Phone:847-910-6368
Mailing Address - Fax:
Practice Address - Street 1:2214 MUSCATINE AVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6600
Practice Address - Country:US
Practice Address - Phone:319-354-2670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21201183500000X
IL051-290098183500000X
MI5302038658183500000X
IA3619240253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy