Provider Demographics
NPI:1578059945
Name:JAMJOOM, OMAR (PHARMD)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:JAMJOOM
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 1:220 W 6TH ST POBOX 210300
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0300
Mailing Address - Country:US
Mailing Address - Phone:803-414-2514
Mailing Address - Fax:
Practice Address - Street 1:220 W 6TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0300
Practice Address - Country:US
Practice Address - Phone:803-414-2514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2377201835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care