Provider Demographics
NPI:1194958462
Name:STANDIFORD, JAMAICA R (PHARM D)
Entity type:Individual
Prefix:
First Name:JAMAICA
Middle Name:R
Last Name:STANDIFORD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7634 LOWER SMITH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:REEDSPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97467-8710
Mailing Address - Country:US
Mailing Address - Phone:541-337-6478
Mailing Address - Fax:
Practice Address - Street 1:1409 HIGHWAY 101 S
Practice Address - Street 2:
Practice Address - City:REEDSPORT
Practice Address - State:OR
Practice Address - Zip Code:97467-1605
Practice Address - Country:US
Practice Address - Phone:541-271-3631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0012764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist