Jeffrey Stephen Jandora, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

9297 Issued in AZ

Practice address

5709 Ginseng Way
Prescott, AZ 86305-3878

Phone

(928) 771-2784

Fax

(928) 771-2784

NPI assigned

Mar 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093847626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5709 GINSENG WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053878",
            "telephone_number": "928-771-2784",
            "fax_number": "928-771-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5709 GINSENG WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053878",
            "telephone_number": "928-771-2784",
            "fax_number": "928-771-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANDORA",
        "first_name": "JEFFREY",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "9297",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00011083",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Pharmacist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.