Provider Demographics
NPI:1396076063
Name:PAJAZETOVIC, JADRANKA TODOR (RPH)
Entity type:Individual
Prefix:
First Name:JADRANKA
Middle Name:TODOR
Last Name:PAJAZETOVIC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9050 W UNION HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382
Mailing Address - Country:US
Mailing Address - Phone:623-566-1986
Mailing Address - Fax:623-566-8149
Practice Address - Street 1:9050 W UNION HILLS DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3023
Practice Address - Country:US
Practice Address - Phone:623-566-1986
Practice Address - Fax:623-566-8149
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist