Provider Demographics
NPI:1154603777
Name:COFFEY, JARROD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JARROD
Middle Name:
Last Name:COFFEY
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 1:2615 BRICE RD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3420
Mailing Address - Country:US
Mailing Address - Phone:614-866-8218
Mailing Address - Fax:614-866-8275
Practice Address - Street 1:2615 BRICE RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3420
Practice Address - Country:US
Practice Address - Phone:614-866-8218
Practice Address - Fax:614-866-8275
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03226350183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist