Provider Demographics
NPI:1518235522
Name:ROE, JENNIFER MICHELLE GAILUS (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MICHELLE GAILUS
Last Name:ROE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6789 W COAL MINE AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-4562
Mailing Address - Country:US
Mailing Address - Phone:720-283-6236
Mailing Address - Fax:720-283-6240
Practice Address - Street 1:6789 W COAL MINE AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-4562
Practice Address - Country:US
Practice Address - Phone:720-283-6236
Practice Address - Fax:720-283-6240
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist