Provider Demographics
NPI:1447580550
Name:VENIER, JONATHAN PETER (REG PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:PETER
Last Name:VENIER
Suffix:
Gender:M
Credentials:REG PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 S VINE ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6817
Mailing Address - Country:US
Mailing Address - Phone:480-262-8749
Mailing Address - Fax:
Practice Address - Street 1:1825 E WARNER RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-3403
Practice Address - Country:US
Practice Address - Phone:480-820-9984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ013038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist