1841587755 NPI number — MIREILLE ARLETTE JONES PHARMD

Table of content: MIREILLE ARLETTE JONES PHARMD (NPI 1841587755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841587755 NPI number — MIREILLE ARLETTE JONES PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
MIREILLE
Provider Middle Name:
ARLETTE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841587755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 S RIVER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT GEORGE
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84790-2116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-627-2037
Provider Business Mailing Address Fax Number:
435-627-2037

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
275 S RIVER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT GEORGE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84790-2116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-627-2037
Provider Business Practice Location Address Fax Number:
435-627-2037
Provider Enumeration Date:
06/30/2011

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:  5945239-1701 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5945239-8911 . This is a "UTAH CONTROLLED SUBSTANCES LICENSE NUMBER" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 5945239-1701 . This is a "UTAH PHARMACIST LICENSE NUMBER" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




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