Provider Demographics
NPI:1467645242
Name:MCKELVEY, JEREMIAH CHARLES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEREMIAH
Middle Name:CHARLES
Last Name:MCKELVEY
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 1:1550 PLATTE ST
Mailing Address - Street 2:APT. 481
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-6115
Mailing Address - Country:US
Mailing Address - Phone:954-465-3024
Mailing Address - Fax:
Practice Address - Street 1:1055 CLERMONT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3808
Practice Address - Country:US
Practice Address - Phone:303-399-8020
Practice Address - Fax:303-370-7506
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist