Provider Demographics
NPI:1467796243
Name:JEE, RICHARD (RPH, MS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:JEE
Suffix:
Gender:M
Credentials:RPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 W FINNIE FLAT ROAD
Mailing Address - Street 2:
Mailing Address - City:CAMP VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:86322
Mailing Address - Country:US
Mailing Address - Phone:928-899-8837
Mailing Address - Fax:928-227-1896
Practice Address - Street 1:475 W FINNIE FLAT RD
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-7398
Practice Address - Country:US
Practice Address - Phone:928-899-8837
Practice Address - Fax:928-227-1896
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ06121183500000X
CA35273183500000X
OH03110827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist