1669870101 NPI number — JENNIFER CARNEY RPH

Table of content: DR. DELORA PINEDA B.S., PHARM D, RPH (NPI 1174806160)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669870101 NPI number — JENNIFER CARNEY RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARNEY
Provider First Name:
JENNIFER
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARNEY-DIAMOND
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1669870101
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 S ASPEN ST
Provider Second Line Business Mailing Address:
STOP 89
Provider Business Mailing Address City Name:
BUCKLEY AIR FORCE BASE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80011-9562
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-847-6049
Provider Business Mailing Address Fax Number:
720-847-7463

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
317 N TELLURIDE ST
Provider Second Line Business Practice Location Address:
BUILDING 7
Provider Business Practice Location Address City Name:
BUCKLEY AIR FORCE BASE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80011-7809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-847-6049
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/16/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  15923 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)