Provider Demographics
NPI:1790061661
Name:OCMAND, JARED (PHARMD)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:OCMAND
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 1:2551 GREENWOOD RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3981
Mailing Address - Country:US
Mailing Address - Phone:318-631-2005
Mailing Address - Fax:318-631-1883
Practice Address - Street 1:2551 GREENWOOD RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3981
Practice Address - Country:US
Practice Address - Phone:318-631-2005
Practice Address - Fax:318-631-1883
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA19101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist