Provider Demographics
NPI:1669193934
Name:SHOOK, JARET KENDALL (PHARMD)
Entity type:Individual
Prefix:
First Name:JARET
Middle Name:KENDALL
Last Name:SHOOK
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 1:9254 E TOWNSHIP ROAD 44
Mailing Address - Street 2:
Mailing Address - City:BLOOMVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44818-9232
Mailing Address - Country:US
Mailing Address - Phone:567-207-7439
Mailing Address - Fax:
Practice Address - Street 1:965 POPLAR ST
Practice Address - Street 2:
Practice Address - City:NELSONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45764-1442
Practice Address - Country:US
Practice Address - Phone:740-753-1984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH034424131835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist