Provider Demographics
NPI:1992937916
Name:MILLS, JARROD MCKAY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JARROD
Middle Name:MCKAY
Last Name:MILLS
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 1:417 MACE BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-6053
Mailing Address - Country:US
Mailing Address - Phone:530-231-6520
Mailing Address - Fax:
Practice Address - Street 1:417 MACE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-6053
Practice Address - Country:US
Practice Address - Phone:530-231-6520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist