Provider Demographics
NPI:1992475826
Name:GENOVESE, JARRETT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JARRETT
Middle Name:
Last Name:GENOVESE
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 1:2222 W FRYE RD APT 3090
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4250
Mailing Address - Country:US
Mailing Address - Phone:732-552-5865
Mailing Address - Fax:
Practice Address - Street 1:4970 S ALMA SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-5502
Practice Address - Country:US
Practice Address - Phone:480-883-0260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025433183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist