Provider Demographics
NPI:1639859580
Name:JEREMY THARAROOP, LLC
Entity type:Organization
Organization Name:JEREMY THARAROOP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:THARAROOP
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:303-276-0282
Mailing Address - Street 1:25587 CONIFER RD # 105-512
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-9067
Mailing Address - Country:US
Mailing Address - Phone:303-276-0282
Mailing Address - Fax:833-765-8253
Practice Address - Street 1:25587 CONIFER RD # 105-512
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-9067
Practice Address - Country:US
Practice Address - Phone:303-276-0282
Practice Address - Fax:833-765-8253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty