Provider Demographics
NPI:1366736134
Name:COLE, JENNIFER F (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:F
Last Name:COLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N MULDOON RD STE F
Mailing Address - Street 2:TARGET PHARMACY STORE NUMBER (T-2371)
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-6105
Mailing Address - Country:US
Mailing Address - Phone:907-269-2101
Mailing Address - Fax:907-269-2101
Practice Address - Street 1:1200 N MULDOON RD STE F
Practice Address - Street 2:TARGET PHARMACY STORE NUMBER (T-2371)
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-6105
Practice Address - Country:US
Practice Address - Phone:907-269-2101
Practice Address - Fax:907-269-2101
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2004183500000X
OK14840183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist