Provider Demographics
NPI:1508293127
Name:PEMBLETON, JUDE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JUDE
Middle Name:
Last Name:PEMBLETON
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 1:1155 E 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-4802
Mailing Address - Country:US
Mailing Address - Phone:303-832-5298
Mailing Address - Fax:303-764-3068
Practice Address - Street 1:1155 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-4802
Practice Address - Country:US
Practice Address - Phone:303-832-5298
Practice Address - Fax:303-764-3068
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19969183500000X
CA60541183500000X
PA441824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist