Provider Demographics
NPI:1538944202
Name:JARC, JESSIE (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:JARC
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:
Other - Last Name:JARC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5071 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2251
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5071 KIPLING ST
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2251
Practice Address - Country:US
Practice Address - Phone:303-209-1849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist