Provider Demographics
NPI:1245643196
Name:LABUDA, JARED (PHARM-D)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:LABUDA
Suffix:
Gender:M
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:PO BOX 1450
Mailing Address - Street 2:
Mailing Address - City:CLAYPOOL
Mailing Address - State:AZ
Mailing Address - Zip Code:85532-1450
Mailing Address - Country:US
Mailing Address - Phone:928-425-7661
Mailing Address - Fax:928-425-0708
Practice Address - Street 1:100 SOUTH RAGUS ROAD
Practice Address - Street 2:
Practice Address - City:CLAYPOOL
Practice Address - State:AZ
Practice Address - Zip Code:85532-1450
Practice Address - Country:US
Practice Address - Phone:928-425-7661
Practice Address - Fax:928-425-0708
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS019205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist