Provider Demographics
NPI:1942238407
Name:ARNOLD, JAYMISON ELLIOTT (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAYMISON
Middle Name:ELLIOTT
Last Name:ARNOLD
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 1:225 LINDEN DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-0472
Mailing Address - Country:US
Mailing Address - Phone:303-819-9815
Mailing Address - Fax:
Practice Address - Street 1:350 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-3455
Practice Address - Country:US
Practice Address - Phone:303-499-2879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist