Provider Demographics
NPI:1538736244
Name:LUNZ, JARED FRANCIS (PHARMD)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:FRANCIS
Last Name:LUNZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 LASHLEY ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-2060
Mailing Address - Country:US
Mailing Address - Phone:352-870-9044
Mailing Address - Fax:
Practice Address - Street 1:645 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5926
Practice Address - Country:US
Practice Address - Phone:303-867-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA0017973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist