Provider Demographics
NPI:1205328820
Name:CHIUSANO, JARED JOSHUA GABRIEL (PHARMD, CPP)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:JOSHUA GABRIEL
Last Name:CHIUSANO
Suffix:
Gender:M
Credentials:PHARMD, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 RIVERVIEW ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-2612
Mailing Address - Country:US
Mailing Address - Phone:828-369-4214
Mailing Address - Fax:
Practice Address - Street 1:834 DEPOT ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-0176
Practice Address - Country:US
Practice Address - Phone:828-349-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26067183500000X
NC7001381835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC26067OtherNC BOARD OF PHARMACY PHARMACIST LICENSE NUMBER
NC700138OtherNC BOARD OF PHARMACY CLINICAL PHARMACIST PRACTITIONER LICENSE NUMBER