Provider Demographics
NPI:1912292897
Name:PALADA, JENNIFER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:PALADA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 THF BLVD
Mailing Address - Street 2:T-1353
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1150
Mailing Address - Country:US
Mailing Address - Phone:636-536-6215
Mailing Address - Fax:636-536-6215
Practice Address - Street 1:40 THF BLVD
Practice Address - Street 2:T-1353
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1150
Practice Address - Country:US
Practice Address - Phone:636-536-6215
Practice Address - Fax:636-536-6215
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2011-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007025605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist