Provider Demographics
NPI:1336668474
Name:SALDANA, JACOB BRANDON (PHARMD)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:BRANDON
Last Name:SALDANA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 MERCURY DR
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:MI
Mailing Address - Zip Code:49224-9103
Mailing Address - Country:US
Mailing Address - Phone:517-936-6683
Mailing Address - Fax:
Practice Address - Street 1:3100 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-3850
Practice Address - Country:US
Practice Address - Phone:517-782-9382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-10
Last Update Date:2017-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302041870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist