Jennifer Lynn Booth, PHARMD
Individual provider Active NPI Pharmacist · Sweet Home, OR
NPI 1124882592 · NPPES record last updated Feb 7, 2024
Key facts
- NPI
- 1124882592
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0019227 (OR)
- Practice address
- 621 Main St Ste a
Sweet Home, OR 97386-3339 - Phone
- (541) 367-6777
- Fax
- (541) 367-6500
- NPI assigned
- Feb 7, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0019227 | OR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Home Town Drugs of Sweet Home Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0019227 | OR | Yes |
Addresses
Primary practice location
621 Main St Ste a
Sweet Home, OR 97386-3339
Mailing address
621 Main St Ste a
Sweet Home, OR 97386-3339
Phone (541) 367-6777
Other providers in Sweet Home, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.