Provider Demographics
NPI:1972989572
Name:BINNEY, JARRED PAUL (PHARM D)
Entity type:Individual
Prefix:
First Name:JARRED
Middle Name:PAUL
Last Name:BINNEY
Suffix:
Gender:M
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 1:13170 DUTCHTOWN POINT AVE
Mailing Address - Street 2:APARTMENT 721
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-0101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1710 N AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-2127
Practice Address - Country:US
Practice Address - Phone:225-644-6547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.021167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist